Identifying patients at risk for high-grade intra-abdominal hypertension following trauma laparotomy

Strang, S.G.; Imhoff, Diederik L. Van; Lieshout, Esther M.M. Van; D’Amours, Scott; Waes, Oscar J.F. Van

doi:10.1016/j.injury.2014.12.020

Cited by 14 publications

(10 citation statements)

References 26 publications

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“…The small number of studies reflects the paucity of data examining the prevalence of IAH in the general ICU population, as well as the delayed adoption of the WSACS recommendation of implementing standardized IAH monitoring protocols. While many studies have been performed to examine the prevalence of IAH in specific populations such as sepsis, [17][18][19] trauma, 20,21 and pancreatitis, 22 the prevalence of IAH in the general ICU population may have been under recognized until recently. The identified studies, though variable in their clinical protocols of IAP monitoring, report an incidence of approximately 30% to 50%, demonstrating that IAH is a common clinical finding in critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Intra-Abdominal Hypertension and Abdominal Compartment Syndrome: A Systematic Review

Khot

Murphy

Sela

et al. 2019

J Intensive Care Med

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Objective: To determine the contemporary prevalence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome in critically ill patients. Data Sources: Medline, Embase, and Central databases. Study Selection: Studies reporting on the prevalence of IAH in consecutively admitted critically ill patients using the World Society of Abdominal Compartment Syndrome (WSACS) consensus guidelines for intra-abdominal pressure (IAP) measurement. Data Extraction: Duplicate independent review and data abstraction. Data Synthesis: The search identified 2428 titles with 6 eligible studies (n = 1965). Reported prevalence ranged from 30% to 49%. Despite abiding by the WSACS guidelines for IAP measurement, studies varied in their definition of IAH, frequency and duration of IAP measurement, and reporting of outcomes. Three of 6 studies reported that IAH, especially at higher grades, was an independent predictor of mortality. Conclusions: Intra-abdominal hypertension is a common finding in critically ill patients and may be associated with increased mortality, especially at higher grades. Further prospective research is required to examine the effect of screening and treatment of IAH on patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Incidence of Intra-Abdominal Hypertension and Abdominal Compartment Syndrome: A Systematic Review

Khot

Murphy

Sela

et al. 2019

J Intensive Care Med

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“…Finally, hemodynamic disturbances during laparoscopic surgery are mainly due to a reduction in venous return. [26–28] Furthermore, reperfusion injury eventually leads to free radical-induced damage, which may contribute to bacterial translocation and septic complications in elderly patients. [29]…”

Section: Discussionmentioning

confidence: 99%

Effects of a multifaceted individualized pneumoperitoneum strategy in elderly patients undergoing laparoscopic colorectal surgery

Liu

Hou

2019

Medicine

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Background: Laparoscopic colorectal surgery may adversely affect respiration, circulation, and acid-base balance in elderly patients, owing to the relatively long duration of CO 2 absorption. We conducted this retrospective study to determine the safety and efficacy of warmed, humidified CO 2 pneumoperitoneum in elderly patients undergoing laparoscopic colorectal surgery. Methods: We enrolled 245 patients between January 2016 and August 2018. The experimental group (warming and humidification group [WH]) received warmed (37°C), humidified (98%) insufflation of CO 2 , and the control group (cold, dry CO 2 /control group [CD]) received standard CO 2 (19°C, 0%). All other aspects of patient care were standardized. Intraoperative hemodynamic data, arterial blood pH, and lactic acid levels were recorded. We also recorded intra-abdominal pressure, incidence of shivering 1 hour after surgery, satisfaction scores of patients and surgeons 24 hours after surgery, times to first flatus/defecation, first bowel movement, and tolerance of semiliquid food, discharge time, and incidence of vomiting, diarrhea, and surgical site infections. Results: Compared with the WH group, heart rate and mean arterial pressure were significantly higher from T3 to T8 ( P < .05), lactic acid levels were significantly higher from T4 to T9 ( P < .05), and recovery time in the post-anesthesia care unit (PACU) was significantly longer in the CD group ( P < .05). Patient and surgeon satisfaction scores were significantly higher in the WH group than the CD group ( P < .05). In addition, the times to first flatus/defecation and bowel movement were significantly longer in the CD group ( P < .05). No significant differences were noted between the groups in the time to tolerance of semiliquid food and time of discharge ( P > .05). The incidence of vomiting, diarrhea, and shivering was significantly lower in the WH group ( P < .05). The number of patients with a shivering grade of 0 was significantly higher in the WH group, whereas the number with a shivering grade of 3 was significantly higher in the CD group ( P < .05). Conclusion: Warmed, humidified insufflation of CO 2 in elderly patients undergoing laparoscopic colorectal surgery could stabilize hemodynamics, and reduce lactic acid levels, recovery time in the PACU, and the incidence of acute gastrointestinal injury-related symptoms.

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“…Nurses should run standard care dealing with patients at risk of IAH and ACS [17]. Hence, prompt screening is essential to find patients who may show IAH and ACS [18]. IAH links to elevated SOFA scores, high APACHE II, high APACHE III, a further need for mechanical ventilation and insufficient PaO2: FiO2 ratios at admission time.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Compartment Syndrome in Critically Ill Patients

Sadeghi¹,

Kiani²,

Sheikhy³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: Abdominal compartment syndrome patients suffer severe obstacles such as kidney failure and shock. To evade further complications, identifying the abdominal compartment syndrome (ACS) and Intra-abdominal hypertension (IAH), in critically ill individuals and hospitalised in the intensive care unit (ICU) is obligated. AIM: The current study intended to study the abdominal compartment syndrome and the concomitant risk factors among hospitalised patients in ICU, by using the Intra-abdominal pressure test. MATERIAL AND METHODS: One hundred and twenty-five hospitalised patients at ICU entered the current survey. Abdominal pressure was measured by standard intravesical technique. The SPSS 21 analysed the preoperative and intraoperative factors such as demographic records and comorbidities. RESULTS: Seventy-three (58.4%) participants were males, and 52 (41.6%) were women in the mean age of 55.1 ± 18.3 years. Eighty-nine patients (71.2%) showed normal intra-abdominal pressure since 31 patients (24.8%), and 5 patients (4%) developed IAH and ACS. The intra-abdominal pressure (IAP) applied to Glasgow Coma Scale (GCS), Acute Physiology, shock, Systemic Inflammatory Response Syndrome (SIRS), central venous oxygen saturation and Chronic Health Evaluation (APACHE II) score (P < 0.05). Patients with high IAP have shown a higher mortality frequency, compared to others (P < 0.05). CONCLUSION: Current findings showed a correlation between IAP hospitalised patients in ICU and shock, SIRS, APACHE II, central venous oxygen saturation and GCS. Intra-abdominal pressure test, as a valuable prognosis test for the abdominal compartment syndrome (ACS) and Intra-abdominal hypertension (IAH), may offer better results when added to the routine medical checkup of ICU patients.

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Identifying patients at risk for high-grade intra-abdominal hypertension following trauma laparotomy

Abstract: Background: Abdominal Compartment Syndrome (ACS) is an uncommon but deleterious

Cited by 14 publications

References 26 publications

Incidence of Intra-Abdominal Hypertension and Abdominal Compartment Syndrome: A Systematic Review

Incidence of Intra-Abdominal Hypertension and Abdominal Compartment Syndrome: A Systematic Review

Effects of a multifaceted individualized pneumoperitoneum strategy in elderly patients undergoing laparoscopic colorectal surgery

Abdominal Compartment Syndrome in Critically Ill Patients

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