The neglected role of abdominal compliance in organ-organ interactions

Malbrain, Manu L N G; Peeters, Yannick; Wise, Robert

doi:10.1186/s13054-016-1220-x

Cited by 71 publications

(60 citation statements)

References 50 publications

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“…Moreover, the abdominal wall itself has recently assumed a greater appreciation in clinical practice and science. Newer thinking very much includes abdominal characteristics and health in conceptualizing models of thoracoabdominal physiology, culminating in the most recent work on abdominal compliance [42,43]. Furthermore, as a frequent and direct consequence of earlier surgery, the burden of disease of abdominal wall failure has been appreciated in both its scope and challenge.…”

Section: The Futurementioning

confidence: 99%

Update from the Abdominal Compartment Society (WSACS) on intra-abdominal hypertension and abdominal compartment syndrome: past, present, and future beyond Banff 2017

Kirkpatrick¹,

Sugrue²,

McKee³

et al. 2017

Anaesthesiol Intensive Ther

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Section: The Futurementioning

confidence: 99%

Update from the Abdominal Compartment Society (WSACS) on intra-abdominal hypertension and abdominal compartment syndrome: past, present, and future beyond Banff 2017

Kirkpatrick¹,

Sugrue²,

McKee³

et al. 2017

Anaesthesiol Intensive Ther

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“…The effect of increasing intra-abdominal volume on the development of IAH. [26][27][28][29]. Abdominal compliance -a measure of the ease of abdominal expansion -differs between individuals (e.g.…”

Section: Blood Supply To the Intestinesmentioning

confidence: 99%

“…Signs of organ dysfunction, duration of mechanical ventilation, ICU length of stay and ICU mortality are increased in most studies [10,11,25]. whether a patient develops IAH or abdominal compartment syndrome (ACS) [9,[26][27][28][29].…”

Section: Pathophysiological Mechanisms Connecting Gi Dysfunction and Iahmentioning

confidence: 99%

“…When increasing IAV, three different phases in an abdominal pressure-volume curve may be distinguished: 1) the reshaping phase, where abdominal configuration changes (ellipsoid to circular circumference) along with a minimal change in IAP; 2) the stretching phase, with elastic elongation of the abdominal wall and diaphragmatic tissue, where IAP increases in parallel with IAV; and 3) the pressurizing phase, with large increases in IAP with relatively small additional IAV [26,27]. Stretching capacity is dependent not only on abdominal wall structure and compliance but also on the shape, elasticity and function of the diaphragm [26].…”

Section: Pathophysiological Mechanisms Connecting Gi Dysfunction and Iahmentioning

confidence: 99%

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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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“…Both layers of the abdominal cavity were closed with 3-0 silk sutures until an IAP of 15 mm Hg was reached. IAP was maintained at this level throughout the experiment, considering we had obtained a large abdominal volume at this pressure consequent to the high abdominal compliance of the rat abdomen [14]. If necessary, more dressings were added or the abdominal suture was tied further to maintain IAP.…”

Section: Animal Preparation and Experimental Protocolmentioning

confidence: 99%

Early impact of abdominal compartment syndrome on liver, kidney and lung damage in a rodent model

Lima¹,

Silva²,

Capelozzi³

et al. 2017

Anaesthesiol Intensive Ther

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Background: Abdominal compartment syndrome (ACS) sometimes occurs in critically ill patients following damage control surgery. The purpose of the present study was to develop a model of ACS and to evaluate its pathologic impact on liver, kidney, and lung morphology. Methods: Twenty Wistar rats (mass 300-350 g) were randomly divided into four groups: 1) intra-abdominal hypertension (IAH): a laparotomy was performed and the abdomen packed with cotton until an intra-abdominal pressure (IAP) of 15 mm Hg was reached; 2) hypovolemia (HYPO): blood was withdrawn until a mean arterial pressure ~60 mm Hg was reached; 3) IAH + HYPO (to resemble clinical ACS); and 4) sham surgery. After 3 hours of protective mechanical ventilation, the animals were euthanized and the liver, kidney and lungs removed to examine the degree of tissue damage. Results: IAH resulted in the following: oedema and neutrophil infiltration in the kidney; necrosis, congestion, and microsteatosis in the liver; and alveolar collapse, haemorrhage, interstitial oedema, and neutrophil infiltration in the lungs. Furthermore, IAH was associated with greater cell apoptosis in the kidney, liver and lungs compared to sham surgery. HYPO led to oedema and neutrophil infiltration in the kidney. The combination of IAH and HYPO resulted in all the aforementioned changes in lung, kidney and liver tissue, as well as exacerbation of the inflammatory process in the kidney and liver and kidney cell necrosis and apoptosis. Conclusions: Intra-abdominal hypertension by itself is associated with kidney, liver and lung damage; when combined with hypovolemia, it leads to further impairment and organ damage.

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The neglected role of abdominal compliance in organ-organ interactions

Cited by 71 publications

References 50 publications

Update from the Abdominal Compartment Society (WSACS) on intra-abdominal hypertension and abdominal compartment syndrome: past, present, and future beyond Banff 2017

Update from the Abdominal Compartment Society (WSACS) on intra-abdominal hypertension and abdominal compartment syndrome: past, present, and future beyond Banff 2017

Abdominal pressure and gastrointestinal function: an inseparable couple?

Early impact of abdominal compartment syndrome on liver, kidney and lung damage in a rodent model

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