Clinical Significance of Increased Intraabdominal Pressure in Severe Acute Pancreatitis

Pupelis, Guntars; Austrums, Edmunds; Snippe, K.; Bērziņš, Māris

doi:10.1080/00015458.2002.11679269

Cited by 58 publications

(58 citation statements)

References 22 publications

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“…Over the past decade, most studies depicted ACS as a terminal prognostic event, with a reported incidence of IAH and ACS in severe disease of 59% to 84% and 25% to 56% respectively [15][16][17][18][19][20][21]. Wide variability within the literature has resulted from small study population sizes, heterogeneous diagnostic criteria, as well as inconsistent methodology for IAP measurement.…”

Section: Acute Pancreatitismentioning

confidence: 99%

“…ACS has been clearly associated with worse outcomes in acute pancreatitis [15]. Over the past decade, most studies depicted ACS as a terminal prognostic event, with a reported incidence of IAH and ACS in severe disease of 59% to 84% and 25% to 56% respectively [15][16][17][18][19][20][21].…”

Section: Acute Pancreatitismentioning

confidence: 99%

“…Bacterial translocation is the most common source of necrosis infection, with gut barrier dysfunction being reported in up to 59% of patients with acute pancreatitis [29]. Late onset ACS may result from intra-abdominal infection, haemorrhage or ischemic complications [15,30], and portends an even worse prognosis [23].…”

Section: Pathophysiologymentioning

confidence: 99%

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Intra-abdominal hypertension and abdominal compartment syndrome in acute pancreatitis, hepato-pancreato-biliary operations and liver transplantation

Bressan

Ball

2017

Anaesthesiol Intensive Ther

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Intra-abdominal hypertension, even preceding the onset of abdominal compartment syndrome, is still recognized as an adverse prognostic factor. Unfortunately, most of the current supporting evidence within the critical care environment remains observational in nature. In acute pancreatitis, an active role for intra-abdominal hypertension early in the disease process follows a strong intuitive basis, and it is corroborated by preliminary evidence from animal models. Additional studies are needed to better characterize the optimal fluid resuscitation strategy, as well as the importance of intra-abdominal hypertension as an early therapeutic target. All critically ill patients with acute pancreatitis should be considered for routine intra-abdominal pressure monitoring. The prevalence and clinical relevance of intra-abdominal hypertension after elective major abdominal operations are underestimated in the literature. Hepato-pancreato-biliary surgery and liver transplantation represent high-risk surgical subspecialties, and routine intra-abdominal hypertension risk assessment to indicate postoperative intra-abdominal pressure monitoring can be recommended. Conservative management of intra-abdominal hypertension should be promptly initiated upon diagnosis. Although abdominal catheter drainage and decompressive laparotomy may be required in refractory cases based on expert clinical judgment, precise indications and timing are still unclear. Implementation of institutional protocols based on the Abdominal Compartment Society reference standards is crucial to optimize both clinical management and research in this evolving area.

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Section: Acute Pancreatitismentioning

confidence: 99%

Section: Acute Pancreatitismentioning

confidence: 99%

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Intra-abdominal hypertension and abdominal compartment syndrome in acute pancreatitis, hepato-pancreato-biliary operations and liver transplantation

Bressan

Ball

2017

Anaesthesiol Intensive Ther

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“…4 Incidence, Risk Factors, and Indications for IAP Monitoring IAH and ACS occur in a wide variety of patients, including infants, children, and adults who require medical or surgical treatment or treatment for burns, and is associated with a variety of diagnoses. 7,[9][10][11][12] The reported incidence of ACS varies from less than 1% to 60%, depending on the definitions used and the different populations of patients studied. 7,8,[12][13][14] Many health care providers think ACS may be underrecognized and thus underreported.…”

Section: Abdominal Compartment Syndrome In Childrenmentioning

confidence: 99%

Abdominal Compartment Syndrome in Children

Newcombe

Mathur

Ejike

2012

Critical Care Nurse

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Abdominal compartment syndrome is defined as sustained intra-abdominal pressure greater than 20 mm Hg (with or without abdominal perfusion pressure <60 mm Hg) associated with new organ failure or dysfunction. The syndrome is associated with 90% to 100% mortality if not recognized and treated in a timely manner. Nurses are responsible for accurately measuring intra-abdominal pressure in children with abdominal compartment syndrome and for alerting physicians about important changes. This article provides relevant definitions, outlines risk factors for abdominal compartment syndrome developing in children, and discusses an instructive case involving an adolescent with abdominal compartment syndrome. Techniques for measuring intra-abdominal pressure, normal ranges, and the importance of monitoring in the critical care setting for timely identification of intra-abdominal hypertension and abdominal compartment syndrome also are discussed.

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“…Finally, intracranial pressure may also be increased due to the decrease in cerebral venous return and increased venous pressure. 4 Increased recognition of its prevalence among the critically ill, combined with advances in both the diagnosis and management of intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS), have resulted in significant improvements in patient survival. 5,6 Current methodology for intra-abdominal pressure assessment relies on the measurement of bladder pressure.…”

Section: Introductionmentioning

confidence: 99%

Correlation of intra-abdominal pressure with the outcome of perforation peritonitis

2017

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Background: A progressive increase in intra-abdominal pressure (IAP) may cause abdominal compartment syndrome (ACS) with organ dysfunction. Studies have documented the impact of Intra-abdominal hypertension (IAH) on virtually every organ. However, it remains strangely underdiagnosed. Present study was aimed to correlate Intra- abdominal pressure with the outcome in perforation peritonitis patients.Methods: This study was done on 50 patients with perforation peritonitis and patients undergoing intervention in the form of either emergency laparotomy or drain placement. The abdominal pressures were indirectly determined by measuring urinary bladder pressure with a Foley's catheter. Pearson correlation was used to see relation between intra-abdominal pressure and outcome of peritonitis.Results: Mean intra-abdominal pressure during time of presentation to the hospital was 26.7±3.2cm H2O. Among various morbidities following operation, surgical site infection was most common (38%) followed by wound dehiscence (24%). There was weak linear correlation between intra-abdominal pressure and factors determining morbidity such as surgical site infection, wound dehiscence, burst abdomen, prolonged ileus, ARDS and ARF. However, this was not statistically significant.Conclusions: There is weak correlation of various co morbidities with increased intra-abdominal pressure in patients with perforation peritonitis which was not significant statistically.

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Clinical Significance of Increased Intraabdominal Pressure in Severe Acute Pancreatitis

Cited by 58 publications

References 22 publications

Intra-abdominal hypertension and abdominal compartment syndrome in acute pancreatitis, hepato-pancreato-biliary operations and liver transplantation

Intra-abdominal hypertension and abdominal compartment syndrome in acute pancreatitis, hepato-pancreato-biliary operations and liver transplantation

Abdominal Compartment Syndrome in Children

Correlation of intra-abdominal pressure with the outcome of perforation peritonitis

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