Effects of increased intra-abdominal pressure and volume expansion on renal function in the rat

Lindström, Pernilla

doi:10.1093/ndt/gfg362

Cited by 44 publications

(30 citation statements)

References 25 publications

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“…Four of seven rodent model studies showed decreases in renal function with pneumoperitoneum. In three rodent model studies [12,24,30] significant decreases in creatinine clearance, sodium excretion, and urine output with a pneumoperitoneum of 8 to 10 mmHg were found. Akbulut et al [1] evaluated rodents using an oxidative stress model.…”

Section: Human Studies Evaluating Renal Functionmentioning

confidence: 97%

Effect of pneumoperitoneum on renal perfusion and function: A systematic review

2007

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Section: Human Studies Evaluating Renal Functionmentioning

confidence: 97%

Effect of pneumoperitoneum on renal perfusion and function: A systematic review

2007

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“…It was shown that pne umo peritoneum of 10 mmHg, resulting from the la pa roscopic surgery techni que, caused a 70% decrease in GFR (32). It was also suggested that the pneumoperitoneum reduced the hepatic portal blood flow, although it did not alter the clinically important postoperative hepatic transaminases (35)(36)(37). In these patients, selection of the anesthetic agent, which has minimal or no effect on renal and hepatic functions, and a low fresh gas flow rate are very important.…”

Section: Discussionmentioning

confidence: 99%

Biochemical Effects of Low-Flow Anesthesia with Inhalation agents in Patients undergoing Laparoscopic Surgery

Sivaci¹,

Demir²,

Köken³

et al. 2012

Journal of Medical Biochemistry

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Summary: This study was designed to investigate the effects of low-flow anesthesia with sevoflurane and desflurane on renal and hepatic functions in patients undergoing laparoscopic abdominal surgery. Twenty patients with ASA I or II (American Society of Anesthesiologists classification) physi cal scores were included in the study. There were no signifi cant differences between sevoflurane and desflurane groups with respect to age, weight, body mass index, duration of the operation and the anesthesia. In both groups, renal function parameters such as urea, BUN, creatinine and calculated creatinine clearance did not show significant differences at 24 and 48 hours. Homocysteine levels, which showed renal metabolic function, did not change significantly at 24 and 48 hours when compared to baseline le vels in both groups. Transaminases were not significantly different between the two groups from baseline to 24 and 48 hours. These differences between the preoperative and post operative values of biochemical parameters were similar for both anes thetic groups (p>0.05). Low-flow anesthesia did not cause impairment in terms of renal and hepatic functions.

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“…111 Ulyatt has suggested that the more important parameter is the glomerular filtration gradient (i.e P GLOMERULAR FILTRATION -P PROXIMAL TUBULE ) which reflects the force across the glomerulus, where in ACS proximal tubular pressure approaches the IAP value and where effectively the glomerular filtration pressure=MABP-IAP. 112 This would suggest that changes in IAP create a unique renal sensitivity over and above changes in the MABP. The renal structure implies a specific vulnerability to the effects of IAH where RPP also is significantly reduced when renal venous pressure is elevated in animal banding studies even in the face of a normal MABP and CO level.…”

Section: Renal Function In Intra-abdominal Hypertensionmentioning

confidence: 99%

Primary Intra-Abdominal Hypertension and Abdominal Compartment Syndrome: Pathophysiology and Treatment

Ap¹,

Wun²,

Chiappa³

et al. 2015

Emerg Med Open J

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Abdominal Compartment Syndrome (ACS) is a potentially lethal condition caused by various events that produce intra-abdominal hypertension. The most common cause is blunt abdominal trauma. Increasing intra-abdominal pressure causes progressive hypoperfusion and ischemia of the intestines and other peritoneal and retroperitoneal structures. Pathophysiological effects include release of cytokines, production of oxygen free radicals, and decreased cellular formation of adenosine triphosphate. These processes may lead to translocation of bacteria from the gut and intestinal edema, predisposing patients to multiorgan dysfunction syndrome. The consequences of abdominal compartment syndrome are profound and affect many vital body systems. Respiratory, hemodynamic, cardiovascular, renal, and neurological abnormalities are signs of abdominal compartment syndrome. Medical management of critically ill patients with raised intra-abdominal pressure should be instigated early to prevent further organ dysfunction and to avoid progression to ACS. Many treatment options are available and are often part of routine daily management in the ICU (nasogastric, rectal tube, prokinetics, enema, sedation, body position). Some of the newer treatments are very promising options in specific patient populations with raised IAP. Nursing care involves vigilant monitoring for early detection, including serial measurements of intra-abdominal pressure.KEYWORDS: Intra-abdominal hypertension; Abdominal compartment syndrome; Damage control laparotomy; Laparostomy; Open abdomen. DEFINITIONS, INCIDENCE AND MEASUREMENT STRATEGIES IN INTRA-ABDOMINAL HY-PERTENSION (IAH) AND ABDOMINAL COMPARTMENT SYNDROME (ACS)The concept of the Abdominal Compartment Syndrome (ACS) has been rediscovered as a final common pathway of the physiologic sequelae of increased Intra-Abdominal Pressure In each case if the graph shifts to the right, higher IAP and lower APP values may not be associated with significant end-organ dysfunction creating a degree of "ACS-resistance." Shifts to the left would create "ACS-sensitivity" where lower values of IAP (higher APP values) may still be associated with organ dysfunction which might not occur normally. This results in difficulty for broader acceptance of critical IAP and APP levels for individual cases. ACS-sensitivity may potentially occur in patients where there is pre-existing partial end-organ failure, morbid obesity or following fluid hyper-resuscitation in patients with severe burns, haemorrhagic pancreatitis, massive blood loss, widespread intra-peritoneal sepsis and high-output intestinal fistulae. 6-8There is no strict definition of what represents abnormal IAP, but there is a general acceptance that measured pressures >12 mmHg when recorded 1-6 hours apart are considered to represent IAH, where Sugrue, et al. have shown that this represents up to 40% of cases admitted to a surgical Intensive Care Unit (ICU). 9 Although there are biases in the prospective assessment of a selective population admitted to an ICU who ...

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Effects of increased intra-abdominal pressure and volume expansion on renal function in the rat

Cited by 44 publications

References 25 publications

Effect of pneumoperitoneum on renal perfusion and function: A systematic review

Effect of pneumoperitoneum on renal perfusion and function: A systematic review

Biochemical Effects of Low-Flow Anesthesia with Inhalation agents in Patients undergoing Laparoscopic Surgery

Primary Intra-Abdominal Hypertension and Abdominal Compartment Syndrome: Pathophysiology and Treatment

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