Intra-abdominal hypertension and abdominal compartment syndrome

Milev, Bosko; Mirković, Darko; Bezmarević, Mihailo; Misovic, Sidor; Mitrović, Miroslav; Jovanović, M.; Mirković, Liljana; Milev, Borka; Radenković, Dejan V

doi:10.2298/vsp1008674m

Cited by 4 publications

(4 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the early stages of severe form of AP, the profound fluid losses in a "third space" associated with inflammation of the pancreas may induce splanchnic vasoconstriction. Hypovolemia also leads to decrease in splanchnic perfusion with consequent cellular hypoxia especially in intestinal mucosa 39,40 . A retroperitoneal and pancreatic inflammation, increased vascular permeability, interstitial edema, decreased intestinal perfusion and cellular and tissue hypoxia lead to development of a vicious circle with the reactivation of immune cells and secretion of de novo synthesized inflammatory mediators [39][40][41] .…”

Section: Pathophysiology Of Acs During Apmentioning

confidence: 99%

“…Hypovolemia also leads to decrease in splanchnic perfusion with consequent cellular hypoxia especially in intestinal mucosa 39,40 . A retroperitoneal and pancreatic inflammation, increased vascular permeability, interstitial edema, decreased intestinal perfusion and cellular and tissue hypoxia lead to development of a vicious circle with the reactivation of immune cells and secretion of de novo synthesized inflammatory mediators [39][40][41] . On the other hand, inflammatory process and increased vascular permeability allows protein-rich intravascular fluid to pass not only in the interstitial space but in the peritoneal cavity also.…”

Section: Pathophysiology Of Acs During Apmentioning

confidence: 99%

“…This is an important issue because the value of IAP determines the severity and further course of AP 13 . In fact, elevated IAP causes intestinal hypoperfusion even at levels from 8 to 12 mmHg 40,48 , while IAH could contribute to pancreas hypoperfusion 13,49,50 . On hospital admission a number of the patients, especially those with severe form of AP, are in hypovolemia which requires aggressive rehydration 42,51,52 .…”

Section: Reperfusion Injury and Iapmentioning

confidence: 99%

See 2 more Smart Citations

Pathophysiology of the abdominal compartment syndrome in acute pancreatitis: Dilemmas and critical points

Bezmarević

2018

VOJNOSANIT PREGL

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Pathophysiology Of Acs During Apmentioning

confidence: 99%

Section: Pathophysiology Of Acs During Apmentioning

confidence: 99%

Section: Reperfusion Injury and Iapmentioning

confidence: 99%

See 1 more Smart Citation

Pathophysiology of the abdominal compartment syndrome in acute pancreatitis: Dilemmas and critical points

Bezmarević

2018

VOJNOSANIT PREGL

Self Cite

View full text Add to dashboard Cite

show abstract

“…Hypovolemia also leads in decreasing in splanchnic perfusion with consequent cellular hypoxia especially in intestinal mucosa. 17,18 It is certain that the gastrointestinal system and liver functions are the most vulnerable to the high Intra-Abdominal Pressure (IAP). Mainly two functions are altered: (1) the mucosal barrier function (influencing both intermucosal nutrient flow and bacterial translocation) and (2) the gastrointestinal motility.…”

mentioning

confidence: 99%

Nutritional Support of Patients with the Abdominal Compartment Syndrome during Severe Acute Pancreatitis

Bezmarević¹,

Panisic-Sekeljic²

2016

Pancreas Open J

Self Cite

View full text Add to dashboard Cite

Short CommunicationThere is growing evidence in the literature that development of Abdominal Compartment Syndrome (ACS) in patients with Severe Acute Pancreatitis (SAP) has a strong impact on the course of disease. Incidence of ACS in patients with SAP is around 20%. The mortality rate in patients who developed ACS during SAP is 49%, while it is 11% in patients without this complication. The development of organ failure in SAP is in correlation with the presence of intra-abdominal hypertension which can deteriorate already compromised pancreatic perfusion and perfusion of gut in early stages of SAP. The latter leads to the alteration of gut functioning with consequent reduced possibility for enteral feeding. Enteral Nutrition (EN) facilitates gut motility and alleviates bacterial translocation, but in patients suffering from ACS during course of SAP could aggravate bowel ischemia. Parenteral nutrition is required as nutritional support in ACS, but it may increase bacterial translocation and deteriorate gut functioning. Since in the literature data there still have not had recommendations regarding nutritional support of patients with ACS during course of SAP, including optimal time for initiation, duration and amount of specific nutritional regiment, in this short review we have tried to give insight into problems in nutritional support in those patients. This should fortify the interest of physicians to make additional research in order to support further strategies for the more optimal nutritional support of patients with this lethal complication.The abdominal compartment syndrome (ACS) is well described entity which importance in various clinical conditions has been recognized in the last two decades. It is defined as a state of serious organ dysfunction resulting from sustained increase in Intra-Abdominal Pressure (IAP).1 There is growing evidence in the literature data that the development of ACS in patients with severe form of acute pancreatitis (SAP) has strong influence on the course of disease.2-5 The incidence of Intra-Abdominal Hypertension (IAH) in patients suffering from SAP is approximately 70%, while ACS can be found in up to 27% of patients with this form of AP.3,4,6,7 When we add to this a mortality rate of 49% in patients with SAP and ACS, 5 it is clear that IAH and ACS have become an issue of concern in patients with AP. In addition, it was recently mentioned that the number of patients with AP and this complication has increased, but still there have not had standard recommendations for interventional treatment of patients who develop ACS during SAP.8 The step-up approach for conservative treatment of ACS was proposed several years ago.9 However, the appropriate interventional procedure, including surgical technique, and optimal time for reacting in the treatment of AP patients suffering from this serious condition is still debated.From a metabolic point of view, SAP is characterized by nitrogen waste and protein catabolism with negative nitrogen balance and secondary malnutrition.10 Similarl...

show abstract

Conservative treatment of abdominal compartment syndrome after large ventral hernia repair

et al. 2012

View full text Add to dashboard Cite

Intra-abdominal hypertension and abdominal compartment syndrome

Abstract: nem

Cited by 4 publications

References 24 publications

Pathophysiology of the abdominal compartment syndrome in acute pancreatitis: Dilemmas and critical points

Pathophysiology of the abdominal compartment syndrome in acute pancreatitis: Dilemmas and critical points

Nutritional Support of Patients with the Abdominal Compartment Syndrome during Severe Acute Pancreatitis

Conservative treatment of abdominal compartment syndrome after large ventral hernia repair

Contact Info

Product

Resources

About