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Intra-abdominal pressure

Natzi Sakalihasan, Jean-Baptiste Michel, Athanasios Katsargyris, Helena Kuivaniemi, Jean-Olivier Defraigne, Alain Nchimi, Janet T Powell, Koichi Yoshimura, Rebecka Hultgren
An abdominal aortic aneurysm (AAA) is a localized dilatation of the infrarenal aorta. AAA is a multifactorial disease, and genetic and environmental factors play a part; smoking, male sex and a positive family history are the most important risk factors, and AAA is most common in men >65 years of age. AAA results from changes in the aortic wall structure, including thinning of the media and adventitia due to the loss of vascular smooth muscle cells and degradation of the extracellular matrix. If the mechanical stress of the blood pressure acting on the wall exceeds the wall strength, the AAA ruptures, causing life-threatening intra-abdominal haemorrhage - the mortality for patients with ruptured AAA is 65-85%...
October 18, 2018: Nature Reviews. Disease Primers
Joerg Krebs, Paolo Pelosi, Patricia R M Rocco, Michael Hagmann, Thomas Luecke
PURPOSE: Pulmonary recruitment and positive end-expiratory pressure (PEEP) titrated according to minimal static elastance of the respiratory system (PEEPEstat,RS ) compared to PEEP set according to the ARDSNetwork table (PEEPARDSNetwork ) as a strategy to prevent ventilator-associated lung injury (VALI) in patients with acute respiratory distress syndrome (ARDS) increases mortality. Alternatively, avoiding negative end-expiratory transpulmonary pressure has been discussed as superior PEEP titration strategy...
October 10, 2018: Journal of Critical Care
Silvia Marchesi, Fracisco Ortiz Nieto, Kerstin Magdalena Ahlgren, Agneta Roneus, Ricardo Feinstein, Miklos Lipcsey, Anders Larsson, Håkan Ahlström, Goran Hedenstierna
Diffusion-weighted magnetic resonance imaging (DW-MRI) uses water as contrast and enables the study of perfusion in many organs simultaneously in situ. We used DW-MRI in a sepsis model, comparing abdominal organs perfusion with global hemodynamic measurements and inflammation. Sixteen anesthetized piglets were randomized into 3 groups: HighMAP (mean arterial pressure, MAP > 65 mmHg), LowMAP (MAP between 50 and 60 mmHg) and Healthy Controls (HC). Sepsis was obtained with endotoxin and the desired MAP maintained with noradrenaline...
October 18, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
Fotini Ampatzidou, Athanasios Madesis, George Kechagioglou, George Drossos
Abdominal compartment syndrome is associated with severe dysfunction of intra-abdominal and intrathoracic organs. Medical therapy, with the goal of reducing intra-abdominal pressure, leads to improvement in organ perfusion.
October 2018: Annals of Cardiac Anaesthesia
Christopher Brown, Shih-Chiao Tseng, Katy Mitchell, Toni Roddey
Purpose: (1) Determine whether ultrasonography can detect differences in diaphragm contractility between body positions. (2) Perform reliability analysis of diaphragm thickness measurements in each test condition. Methods: We used a repeated-measures experimental design with 45 healthy adults where 3 B-mode ultrasound images were collected at peak-inspiration and end-expiration in supine, sitting, and standing. Mean diaphragm thickening fractions were calculated for each test position...
October 2018: Cardiopulmonary Physical Therapy Journal
S van Steensel, A Bloemen, L C L van den Hil, J van den Bos, G J Kleinrensink, N D Bouvy
PURPOSE: The lumbar abdominal wall hernia is a rare hernia in which abdominal contents protrude through a defect in the dorsal abdominal wall, which can be of iatrogenic, congenital, or traumatic origin. Two anatomical locations are known: the superior and the inferior lumbar triangle. The aim of this systematic review is to provide a clear overview of the existing literature and make practical clinical recommendations for proper diagnosis and treatment of the primary lumbar hernia. METHODS: The systematic review was conducted according to the PRISMA guidelines...
October 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Kyoung Hoon Lim, Jinyoung Park
Blunt traumatic diaphragmatic rupture (BTDR) is uncommon, but is associated with high rates of morbidity and mortality. The purpose of this study was to present our experience with management of this injury. Medical records of 38 patients with BTDR who were treated in our hospital from January 2001 to June 2016 were analyzed retrospectively. The sex, age, cause of injury, location of rupture, mode of diagnosis, time to diagnosis, the presence of herniation and bowel perforation, the presence of preoperative shock and intubation, Injury Severity Score (ISS), associated injuries, comorbidity, the operative procedure, morbidity and mortality, and the predictive factors affecting the outcome of BTDR were evaluated...
October 2018: Medicine (Baltimore)
Christopher J Goodenough, Tyler A Cobb, John B Holcomb
Resuscitative endovascular balloon occlusion of the aorta (REBOA) has become an increasingly popular alternative to emergency thoracotomy and aortic cross-clamping in patients with exsanguinating hemorrhage.1 This new capability is increasingly being used in non-trauma situations.2 3 This report demonstrates another novel use of REBOA for iatrogenic intra-abdominal hemorrhage. An 83-year-old man with multiple medical comorbidities and a history of chronic mesenteric ischemia was admitted to our institution for an elective mesenteric revascularization...
2018: Trauma surgery & acute care open
Sadegh Toutounchi, Ryszard Pogorzelski, Małgorzata E Legocka, Ewa Krajewska, Krzysztof Celejewski, Urszula Ambroziak, Zbigniew Gałązka
Introduction: Lateral transabdominal adrenalectomy (LTA) is the most common minimally invasive technique used to treat patients with adrenal tumors. Aim: To analyze intra-operative and post-operative complications and reasons for conversion to open surgery in patients who underwent LTA and had previous abdominal surgery. Material and methods: Five hundred and nineteen patients underwent LTA in our center between 2005 and 2016. We identified a study group of 150 patients, with previous abdominal surgery...
September 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Mostafa M Hussein
PURPOSE: Quadratus lumborum (QL) block has four approaches. However, there is difference between the four approaches regarding efficacy, safety and adverse effects. The primary objective of this study is to compare the analgesic effect between trans-muscular and intra-muscular approaches of the QL block in pediatric patients for elective lower abdominal surgery. METHODS: 54 patients aged between 1 and 6 years were enrolled. Patients of both genders were selected...
October 5, 2018: Journal of Anesthesia
U A Khan, A Giamouriadis, R S Bhangoo
Idiopathic intracranial hypertension is strongly associated with central obesity and consequential raised intra-abdominal pressure. If left untreated it poses significant risk to vision and can eventually cause blindness. Owing to its pathophysiology, this condition is managed by both medical and surgical specialities. When medical management fails neurosurgeons commonly treat idiopathic intracranial hypertension by permanent cerebrospinal fluid peritoneal shunting. Weight reduction surgery provides patients who are obese with a multitude of benefits and it is not uncommon for the general surgeon to be presented with a patient with idiopathic intracranial hypertension and a cerebrospinal fluid peritoneal shunt in place...
October 5, 2018: Annals of the Royal College of Surgeons of England
Yoshifumi Morita, Takanori Sakaguchi, Ryo Kitajima, Satoru Furuhashi, Ryota Kiuchi, Makoto Takeda, Takanori Hiraide, Yasushi Shibasaki, Hirotoshi Kikuchi, Yuji Suzuki, Kei Tsukamoto, Tomoharu Matsuura, Hiroya Takeuchi
Pancreatic cancer often invades the duodenum and causes obstruction, but rarely causes massive duodenal bleeding. A 68-year-old male was admitted to our hospital because of vomiting. Enhanced abdominal CT showed a hypovascular tumor with air bubbles in the uncinate process of the pancreas. The tumor invaded the duodenum and metastasized to the liver and peritoneum. The main trunk of the superior mesenteric artery (SMA) was circumferentially involved. After admission, he had hematemesis and melena. Emergency gastroduodenoscopy revealed pulsating vessels in the third portion of the duodenum and he eventually experienced hemorrhagic shock...
May 2018: Case Reports in Gastroenterology
Soichiro Ide, Ryuta Yamamoto, Hacchi Suzuki, Hiroshi Takeda, Masabumi Minami
AIMS: The bed nucleus of the stria terminalis (BNST) is a limbic structure mediating autonomic and neuroendocrine responses and negative affective states such as anxiety and fear. We previously demonstrated that noradrenergic transmission via β-adrenoceptors within the ventral part of BNST (vBNST) is involved in bidirectional interactions between the brain and the upper gastrointestinal (GI) tract. The present study aimed to examine the roles of intra-vBNST noradrenergic transmission via β-adrenoceptors in bidirectional interactions between the brain and lower GI tract...
September 27, 2018: Neuropsychopharmacology reports
Xiukai Chen, Xiaoting Wang, Patrick M Honore, Herbert D Spapen, Dawei Liu
The central venous pressure (CVP) is traditionally used as a surrogate of intravascular volume. CVP measurements therefore are often applied at the bedside to guide fluid administration in postoperative and critically ill patients. Pursuing high CVP levels has recently been challenged. A high CVP might impede venous return to the heart and disturb microcirculatory blood flow which may cause tissue congestion and organ failure. By imposing an increased "afterload" on the kidney, an elevated CVP will particularly harm kidney hemodynamics and promote acute kidney injury (AKI) even in the absence of volume overload...
September 20, 2018: Annals of Intensive Care
Wei-Jyh Chen, I-Chen Wu, Chun-Chieh Wu, Fang-Jung Yu
INTRODUCTION: Peritoneal angiosarcoma is an extremely rare sarcoma (0.01287% incidence per 100,000) with an aggressive course and a poor prognosis. In this case, the manifestation of peritoneal angiosarcoma was ascites, which caused difficulty in early diagnosis and the diagnosis of peritoneal angiosarcoma, was made only after the surgery. PATIENT CONCERNS: A 61-year-old man working in Mainland China presented with a 1-month history of abdominal distension. A contrast-enhanced abdominal computed tomography (CT) scan revealed peritoneal carcinomatosis with massive ascites...
September 2018: Medicine (Baltimore)
Ekrem Islamoglu, Bulent Cekic, Ali Yildiz, Kamil Sarac, Kaan Karamik, Murat Savas
BACKGROUND: We aimed to investigate the effects of intra-abdominal pressure and steep Trendelenburg position on the intrarenal vascular parameters and estimated glomerular filtration rate (eGFR) in the first 24 hours of robot-assisted radical prostatectomy (RARP) surgery. METHODS: We prospectively studied 31 men who underwent RARP for prostate cancer in our clinic between September and December 2017. Preoperative color Doppler ultrasonographic (CDUS) measurements of renal intravascular parameters were obtained 24 hours before the operation...
September 14, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Mircea Muresan, Simona Muresan, Klara Brinzaniuc, Daniela Sala, Radu Neagoe
INTRODUCTION: Open abdomen is a concept that was developed especially in relation to abdominal compartment syndrome (ACS). OBJECTIVE: This study presents the evolution and complications related to the management of the open abdomen after decompressive laparotomy, using a standardized method based on negative pressure wound therapy (NPWT). MATERIALS AND METHODS: This observational prospective study conducted over a 9-month period included 19 patients who underwent decompressive laparotomies for ACS...
August 13, 2018: Wounds: a Compendium of Clinical Research and Practice
Steven L Ciciora, Frederick W Woodley
Gastroesophageal reflux (GER) is the retrograde movement of gastric (and sometimes duodenal) contents into the esophagus. While the majority of GER is physiologic, for patients, it can be associated with symptoms. While some symptoms are merely bothersome (crying), others can be life threatening (cough, gagging, choking). The main driver of GER in infants is the frequent feedings that produce increased intra-abdominal pressure, which is known to trigger transient relaxations of the lower esophageal sphincter...
September 10, 2018: Paediatric Drugs
Allert M de Vries, Pieter L Venema, John P F A Heesakkers
BACKGROUND AND OBJECTIVES: The pathophysiology of female stress urinary incontinence (SUI) is far from unraveled. Capturing all aspects of this bothersome condition in one theory remains challenging. The well-known Hammock and Integral theories, both from the early 90's, were successful in explaining a large proportion of the observations made in clinical practice. Nevertheless, some (pre)clinical observations cannot be explained by the current understanding. One of the issues concerns the pressure transmission...
September 6, 2018: Neurourology and Urodynamics
Asha Tyagi, Shubham Lahan, Gaurav Verma, Shukla Das, Mahendra Kumar
Aims: This prospective cohort study evaluated intra-abdominal pressure (IAP) and its role in causing acute kidney injury (AKI) in critically ill obstetric patients and utility of urinary neutrophil gelatinase-associated lipocalin (NGAL) to predict AKI. Methods: A total of 50 eligible obstetric patients admitted to our Intensive Care Unit were enrolled and daily IAP measured using indwelling Foley catheter. Early AKI was diagnosed as per the KDIGO criteria and urine assessed for NGAL using ELISA...
August 2018: Indian Journal of Critical Care Medicine
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