Increased maternal intraabdominal pressure alters the contractile properties of fetal rabbit bladder

Karnak, İbrahìm; E, Aksöz; Ekinci, Saniye; Onur, Rüştü; Tanyel, Feridun Cahit

doi:10.1016/j.jpedsurg.2008.01.025

Cited by 8 publications

(10 citation statements)

References 22 publications

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“…Several animal studies have confirmed that the mammalian fetus in utero is subject to transmitted IAP [57,58,63]. IAH was found to decrease uterine blood flow and induced a resultant compensatory fetal hypertension [64] similar to that seen during laparoscopy even with inert gasses rather than CO 2 .…”

Section: Intra-abdominal Hypertension During Pregnancy Pathophysiologmentioning

confidence: 85%

“…In a gravid rabbit model, Karnak et al found that intra-amniotic pressure (IAMNP) was linearly related to IAP as defined by IAMNP = IAP × 0.8 + 2.0. The IAP and IAMNP were measured through catheters inserted respectively into both the intraperitoneal and intraamniotic cavities at 20 days gestation [58]. Given the increasing tolerance for laparoscopic surgery in gravid females, further research in this area is of critical importance.…”

Section: Intra-abdominal Hypertension During Pregnancy Pathophysiologmentioning

confidence: 99%

See 1 more Smart Citation

Intra-abdominal hypertension and abdominal compartment syndrome in burns, obesity, pregnancy, and general medicine

Malbrain¹,

Keulenaer²,

Oda³

et al. 2015

Anaesthesiol Intensive Ther

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Intra-abdominal hypertension (IAH) is an important contributor to early organ dysfunction in trauma and sepsis. However, relatively little is known about the impact of intra-abdominal pressure (IAP) in general internal medicine, pregnant patients, and those with obesity or burns. The aim of this paper is to review the pathophysiologic implications and treatment options for IAH in these specific situations. A MEDLINE and PubMed search was performed and the resulting body-of-evidence included in the current review on the basis of relevance and scientific merit. There is increasing awareness of the role of IAH in different clinical situations. Specifically, IAH will develop in most (if not all) severely burned patients, and may contribute to early mortality. One should avoid over-resuscitation of these patients with large volumes of fluids, especially crystalloids. Acute elevations in IAP have similar effects in obese patients compared to non-obese patients, but the threshold IAP associated with organ dysfunction may be higher. Chronic elevations in IAP may, in part, be responsible for the pathogenesis of obesity-related co-morbid conditions such as hypertension, pseudotumor cerebri, pulmonary dysfunction, gastroesophageal reflux disease, and abdominal wall hernias. At the bedside, measuring IAP and considering IAH in all critical maternal conditions is essential, especially in preeclampsia/eclampsia where some have hypothesized that IAH may have an additional role. IAH in pregnancy must take into account the precautions for aorto-caval compression and has been associated with ovarian hyperstimulation syndrome. Recently, IAP has been associated with the cardiorenal dilemma and hepatorenal syndrome, and this has led to the recognition of the polycompartment syndrome. In conclusion, IAH and ACS have been associated with several patient populations beyond the classical ICU, surgical, and trauma patients. In all at risk conditions the focus should be on the early recognition of IAH and prevention of ACS. Patients at risk for IAH should be identified early through measurements of IAP. Appropriate actions should be taken when IAP increases above 15 mm Hg, especially if pressures reach above 20 mm Hg with new onset organ failure. Although non-operative measures come first, surgical decompression must not be delayed if these fail. Percutaneous drainage of ascites is a simple and potentially effective tool to reduce IAP if organ dysfunction develops, especially in burn patients. Escharotomy may also dramatically reduce IAP in the case of abdominal burns.

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Section: Intra-abdominal Hypertension During Pregnancy Pathophysiologmentioning

confidence: 85%

Section: Intra-abdominal Hypertension During Pregnancy Pathophysiologmentioning

confidence: 99%

Intra-abdominal hypertension and abdominal compartment syndrome in burns, obesity, pregnancy, and general medicine

Malbrain¹,

Keulenaer²,

Oda³

et al. 2015

Anaesthesiol Intensive Ther

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show abstract

“…Chronically elevated IAP leads the organism to chronic adaptations and not to the deleterious effects of compartment syndromes. We know that in otherwise healthy subjects, IAP is constantly increased in visceromegaly [21] pregnancy [1,2], and of course, obesity [1,[5][6][7], Additionally, IAP is chronically increased in various pathologic conditions, such as ascites [3,4], large cysts (parasitic or not) [10,22,23], and large neoplasmatic formations [24]. Finally, iatrogenically increased IAP, to a near chronically basis, is induced by the plastic surgeons in order to repair large hernias (ventral or inguinal) [25,26], or in the context of pulmonary tuberculosis with resistant mycobacteria [27].…”

Section: Discussionmentioning

confidence: 99%

“…Chronically increased IAP is every IAP elevated for more than 8 weeks, and it is normally observed in pregnancy [1,2], while it is also observed in several pathologic conditions, such as ascites [3,4] and morbid obesity [1,[5][6][7]. Harvey Sugerman pioneered many studies implying that chronically increased IAP may be in the center of many obesity complications.…”

Section: Introductionmentioning

confidence: 99%

Chronically Increased Intra-abdominal Pressure: Validating a Model

et al. 2010

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“…Chronically increased IAP is every IAP elevated to more than 12 mmHg for more than 8 weeks without producing any acute organ dysfunction [7], and it normally characterizes pregnancy [8], while it is also observed in pathologic conditions, like morbid obesity [9][10][11] and ascites [12]. Chronic IAP elevation is also described in splenomegaly, hepatomegaly [13], large cysts and pseudocysts [14], retroperitoneal tumors, and hematomas [15].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Chronically Increased Intra-abdominal Pressure on the Rabbit Diaphragm

et al. 2012

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Increased maternal intraabdominal pressure alters the contractile properties of fetal rabbit bladder

Cited by 8 publications

References 22 publications

Intra-abdominal hypertension and abdominal compartment syndrome in burns, obesity, pregnancy, and general medicine

Intra-abdominal hypertension and abdominal compartment syndrome in burns, obesity, pregnancy, and general medicine

Chronically Increased Intra-abdominal Pressure: Validating a Model

The Effects of Chronically Increased Intra-abdominal Pressure on the Rabbit Diaphragm

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