Moderate Increase in Intraabdominal Pressure Attenuates Gastric Mucosal Oxygen Saturation in Patients Undergoing Laparoscopy

Schwarte, Lothar A.; Scheeren, Thomas; Lorenz, Christian; Bruyne, F. De; Fournell, A.

doi:10.1097/00000542-200405000-00009

Cited by 57 publications

(51 citation statements)

References 44 publications

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“…RESULTS: IAH within the first week after admission was found in 44 patients (59.46%). Although the APACHE Ⅱ scores on admission and the Ranson scores within 48 h after hospitalization were elevated in IAH patients in early stage, they did not show the statistically significant differences from patients with normal IAP within a week after admission (16.18 ± 3.90 vs 15.70 ± 4.25, P = 0.616; 3.70 ± 0.93 vs 3.47 ± 0.94, P = 0.285, respectively). ACS in early AP was recorded in 20 patients (27.03%).…”

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confidence: 70%

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Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage

Chen¹,

Li²,

Sun³

et al. 2008

WJG

123

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AIM:To study retrospectively the influence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in patients with early acute pancreatitis (AP) (during the first week after admission) on physiological functions, and the association of the presence of IAH/ACS and outcome. METHODS: Patients (n = 74) with AP recruited in this study were divided into two groups according to intra-abdominal pressure (IAP) determined by indirect measurement using the transvesical route via Foley bladder catheter during the first week after admission. Patients (n = 44) with IAP ≥ 12 mmHg were assigned in IAH group, and the remaining patients (n = 30) with IAP < 12 mmHg in normal IAP group. For analysis of the influence of IAH/ACS on organ function and outcome, the physiological parameters and the occurrence of organ dysfunction during intensive care unit (ICU) stay were recorded, as were the incidences of pancreatic infection and in-hospital mortality. RESULTS: IAH within the first week after admission was found in 44 patients (59.46%). Although the APACHE Ⅱ scores on admission and the Ranson scores within 48 h after hospitalization were elevated in IAH patients in early stage, they did not show the statistically significant differences from patients with normal IAP within a week after admission (16.18 ± 3.90 vs 15.70 ± 4.25, P = 0.616; 3.70 ± 0.93 vs 3.47 ± 0.94, P = 0.285, respectively). ACS in early AP was recorded in 20 patients (27.03%). During any 24-h period of the first week after admission, the recorded mean IAP correlated significantly with the Marshall score calculated at the same time interval in IAH group (r = 0.635, P < 0.001). Although ACS patients had obvious amelioration in physiological variables within 24 h after decompression, the incidences of pancreatitic infection, septic shock, multiple organ dysfunction syndrome (MODS) and death in the patients with ACS were significantly higher than that in other patients without ACS (pancreatitic infection: 60.0% vs 7.4%, P < 0.001; septic shock: 70.0% vs 11.1%, P < 0.001; MODS: 90.0% vs 31.5%, P < 0.001; mortality: 75.0% vs 3.7%, P < 0.001). CONCLUSION: IAH/ACS is

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confidence: 70%

“…Manifestations of ACS include cardiovascular, pulmonary, renal, splanchnic and neurologic impairment. Hypoperfusion of the gastrointestinal tract was reported at IAP of 12 mmHg [15] . Oliguria and marked reduction in cardiac output have been shown to develop at an IAP greater than 20 mmHg [16,17] .…”

Section: Discussionmentioning

confidence: 99%

Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage

Chen¹,

Li²,

Sun³

et al. 2008

WJG

123

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“…Both factors are likely to decrease peripheral tissue oxygen tension. Increased intra-abdominal pressure due to pneumoperitoneum additionally reduces microcirculatory flow (7). Furthermore the hemodynamic effects of the pneumoperitoneum are likely be even more pronounced in the morbidly obese (8)(9)(10).…”

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confidence: 99%

Tissue Oxygenation in Obese and Non-obese Patients During Laparoscopy

Fleischmann¹,

Kurz²,

Niedermayr³

et al. 2005

OBES SURG

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“…Such a dose-dependent relationship between IAP and microcirculatory gastric mucosal oxygen saturation has also been demonstrated in humans undergoing laparoscopy [68]. However, in humans, an IAP in the range of 12 to 15 mm Hg for a short time period, as used during laparoscopic procedures, is unlikely to cause clinically manifesting organ dysfunction, whereas prolonged exposure to higher IAP levels is more likely to cause tissue hypoperfusion and damage at a cellular level [24].…”

Section: Effects Of Iah On Tissue Perfusion and Microcirculationmentioning

confidence: 84%

Abdominal pressure and gastrointestinal function: an inseparable couple?

Blaser¹,

Malbrain²,

Regli³

2017

Anaesthesiol Intensive Ther

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Evaluating the degree of organ dysfunction is a cornerstone in distinguishing patients with critical illness from those without. However, evaluation of the gastrointestinal function in critically ill patients is not unified, and is still largely based on subjective clinical evaluation. Although intra-abdominal pressure has been proposed as a parameter to facilitate monitoring of abdominal compartment in critical illness, the interactions between intra-abdominal pressure and gastrointestinal function are poorly clarified. The aim of this current review is to describe interactions and associations between gastrointestinal dysfunction and intra-abdominal pressure from a pathophysiological and clinical point of view.

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Moderate Increase in Intraabdominal Pressure Attenuates Gastric Mucosal Oxygen Saturation in Patients Undergoing Laparoscopy

Abstract: The results suggest that increasing intraabdominal pressure to moderate levels, commonly applied to induce a surgical pneumoperitoneum, decreases gastric mucosal oxygen saturation.

Cited by 57 publications

References 44 publications

Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage

Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage

Tissue Oxygenation in Obese and Non-obese Patients During Laparoscopy

Abdominal pressure and gastrointestinal function: an inseparable couple?

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