The Complex Surgical Abdomen

Cohen, Wess A.; Horovitz, Joel; Kupfer, Yizhak; Savel, Richard H.

doi:10.1177/0885066615569974

J Intensive Care Med

2015

DOI: 10.1177/0885066615569974

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The Complex Surgical Abdomen

Wess A. Cohen

Joel Horovitz

Yizhak Kupfer

et al.

Abstract: Intensivists are often called upon to help care for patients who develop severe sepsis syndrome and septic shock where the primary source is an enterocutaneous fistula (ECF). The purpose of this article is to describe to the nonsurgeon intensivist how these complex surgical situations arise in the first place and provide the reader with a detailed understanding of the potentially devastating complications of ECF. In addition, we will describe a structured algorithm regarding the management of this often highly… Show more

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2016

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Cited by 1 publication

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Intra-abdominal Pressure Monitoring in Open Abdomen Management with Dynamic Abdominal Closure

Sarer¹,

Yetışır²,

Aygar³

et al. 2016

Indian J Surg

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The importance of elevated intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) have been recognized in critical care for its potential damaging effects. But, quantification of IAP values may be useful as a clinical tool for determining efficacy of coughing and straining for functional recovery of OA patients. We would like to evaluate IAP generated in an OA patient and the effect of negative pressure therapy (NPT) and dynamic abdominal closure systems (ABRA) on the IAP values at rest and during coughing and straining and compare those with IAP measurements of closed abdomen after standard open elective colorectal surgery (non-OA). Eight OA and eight non-OA patients were included in this study. OA patient with NPT and ABRA (OA + NA), OA patient without NPT and ABRA completely unbraced (OA-NA) (NA stands for NPT and ABRA), and non-OA patients underwent IAP measurements at rest, during coughing, and during straining via transurethral catheter. There was no difference in the mean of IAP measurement at rest in OA-NA (6.1 mmHg), OA + NA (6.5 mmHg), and non-OA (6.0 mmHg) patients. During coughing, IAP of OA-NA, OA + NA, and non-OA patients were 11.5, 19.1, and 22.0 mmHg and during straining, IAP of OA-NA, OA + NA, and non-OA patients were 11.5, 17.5, and 23.5 mmHg, respectively. Application of NPT in conjunction with ABRA did not increase IAP at rest but provided significant IAP increase in OA + NA patients, when compared to OA-NA patients during coughing and straining. NPT in conjunction with ABRA offers the advantage of increase of IAP during coughing and straining.

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Intra-abdominal Pressure Monitoring in Open Abdomen Management with Dynamic Abdominal Closure

Sarer¹,

Yetışır²,

Aygar³

et al. 2016

Indian J Surg

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The Complex Surgical Abdomen

Cited by 1 publication

References 30 publications

Intra-abdominal Pressure Monitoring in Open Abdomen Management with Dynamic Abdominal Closure

Intra-abdominal Pressure Monitoring in Open Abdomen Management with Dynamic Abdominal Closure

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