Induced abdominal compartment syndrome increases intracranial pressure in neurotrauma patients: A prospective study

Citerio, Giuseppe; Vascotto, E; Villa, Federico; Celotti, Simona; Artigas, Antonio

doi:10.1097/00003246-200107000-00027

Cited by 184 publications

(96 citation statements)

References 21 publications

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“…Increased venous pressure could perhaps reduce the pressure gradient for cerebral venous drainage. Our findings agree with the current literature (6)(7)(8) and broaden the knowledge of body compartments.…”

Section: Discussionsupporting

confidence: 93%

See 1 more Smart Citation

Modulação da pressão intracraniana em um modelo experimental de hipertensão abdominal e lesão pulmonar aguda

Zampieri¹,

Almeida²,

Schettino³

et al. 2011

Rev. bras. ter. intensiva

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Section: Discussionsupporting

confidence: 93%

“…Intra-thoracic (ITP) and intra-abdominal pressures (IAP) are known to influence ICP. (6)(7)(8) However, the magnitude of this effect and its clinical relevance, except in acute neurological diseases, are unknown.…”

Section: Introductionmentioning

confidence: 99%

Modulação da pressão intracraniana em um modelo experimental de hipertensão abdominal e lesão pulmonar aguda

Zampieri¹,

Almeida²,

Schettino³

et al. 2011

Rev. bras. ter. intensiva

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“…This is potentially relieved by abdominal decompression as well as by central volume expansion and PEEP ventilation. 153 The dynamics of the effect of IAP on ICP are different if there is a concomitant traumatic or nontraumatic brain injury, 154 although in patients with brain trauma and IAH, a more liberal approach towards decompressive laparotomy and a more judicious delay in closure of the open abdomen when it is employed is indicated.…”

Section: Miscellaneous Pathophysiology and Intra-abdomi-nal 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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“…Elevations in central venous and jugular venous pressures result in increased resistance to cerebral outflow, which causes an increase in ICP and decrease in CPP. 35 Animal experiments have demonstrated that IAH of >20 mmHg causes significant increases in ICP and decreases in CPP. Additionally, elevations in CSF lactate and interleukin-6 were also seen, suggesting the associated presence of cerebral ischemia.…”

Section: Concurrent Abdominal Injurymentioning

confidence: 99%

Competing Priorities in the Brain Injured Patient: Dealing with the Unexpected

Wisler¹,

Beery²,

Steinberg³

et al. 2012

Brain Injury - Pathogenesis, Monitoring, Recovery and Management

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Induced abdominal compartment syndrome increases intracranial pressure in neurotrauma patients: A prospective study

Cited by 184 publications

References 21 publications

Modulação da pressão intracraniana em um modelo experimental de hipertensão abdominal e lesão pulmonar aguda

Modulação da pressão intracraniana em um modelo experimental de hipertensão abdominal e lesão pulmonar aguda

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

Competing Priorities in the Brain Injured Patient: Dealing with the Unexpected

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