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intraabdominal hypertension

Erika B Rosenzweig, Darryl Abrams, Mauer Biscotti, Diane Kerstein, Daphnie Drassinower, Daniel Brodie, Matthew Bacchetta
Pregnancy is typically contraindicated in Eisenmenger syndrome because of its association with excessively high maternal and fetal morbidity and mortality. We report on our novel approach to successfully managing a 29 year-old pregnant woman with an unrepaired patent ductus arteriosus (PDA) with Eisenmenger syndrome through delivery and recovery. Venovenous ECMO was utilized during induction of labor to stabilize maternal hemodynamics and optimize fetal oxygenation by creating an oxygenated right-to-left shunt through the PDA...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Tamara M Atkinson, George D Giraud, Brandon M Togioka, Daniel B Jones, Joaquin E Cigarroa
Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance...
February 14, 2017: Circulation
Özlem Boybeyi, Elem İnal, Yasemin Dere Günal, Mustafa Kemal Aslan, Gülümser Aydin, Tutku Soyer
BACKGROUND/AIM: The aim of this study was to electrophysiologically evaluate the effect of increased intraabdominal pressure (IAP) on genitofemoral nerve (GFN) motor conduction. MATERIALS AND METHODS: Seven Wistar albino rats were included. After anesthetization, latency and duration of GFN conduction was recorded with a needle-probe at rest. IAP was increased to 15 mmHg by insufflating atmospheric air with a percutaneous intraperitoneal needle. At 30 min of IAP, GFN motor conduction was recorded...
2016: Turkish Journal of Medical Sciences
Benjamin R Biteman, James A Randall, Fred Brody
INTRODUCTION: Since laparoscopic adrenalectomy for pheochromocytoma was reported in 1992, the laparoscopic technique has largely replaced the open approach [4]. Numerous studies have demonstrated that the laparoscopic approach is associated with decreased blood loss, shorter hospitalization, faster recovery, and lower cost [1]. Conversion rates are reported at less than 5.5 %, yet concern still exists that intraoperative hypertensive crisis may be more severe with laparoscopy due to increased intraabdominal pressure [3]...
December 2016: Surgical Endoscopy
Christopher Lau, Padraic O'Malley, Mario Gaudino, Douglas S Scherr, Leonard N Girardi
BACKGROUND: Intraabdominal malignancies with cavoatrial extension can be resected using cardiopulmonary bypass and deep hypothermic circulatory arrest (DHCA). METHODS: Twenty-five consecutive patients underwent resection of intraabdominal tumor with cavoatrial thrombectomy using DHCA at a single tertiary center. Recurrence-free survival, cancer-specific survival, and overall survival were estimated using Kaplan-Meier analysis. RESULTS: All patients had renal artery embolization preoperatively...
September 2016: Annals of Thoracic Surgery
Zheng Lou, Fei-Hu Yan, Shi-Jie Hu, Rong-Gui Meng, Wei Zhang, En-da Yu, Chuan-Gang Fu
Adhensive small-bowel obstruction (SBO) remains a common cause of admission to surgical wards around the world. Given the growing elderly population, the number of elderly patients with adhensive SBO can be expected to increase substantially. Timely and appropriate treatment would improve morbidity and mortality rates in elderly patients with adhensive SBO. However, accurately determining which patients should undergo surgical treatment during the hospitalization remains difficult. The aim of this study was to identify predictive factors for surgical intervention in patients aged over 80 years presenting with SBO due to postoperative adhesions...
December 2015: Indian Journal of Surgery
I V Khomyak, Yu O Furmanov, I M Savytska, O V Kit, A I Khomyak
In experiment the impact of intraabdominal hypertension (IAH) on an acute pancreatitis (AP) course was studied up. The procedure of an acute experiment, using intraparenchymatose introduction of 40% solution of ethanol, was proposed. The isolated influence of IAH on target organs was investigated, as well as its impact on the simulated severe AP course. Morphological changes in pancreas, small intestine, kidneys, liver in an AP were studied up. While performing the investigation a negative impact of IAH in AP was noted, such as the polyorgan insufficiency occurence...
October 2015: Klinichna Khirurhiia
O M Pavlova
The impact of intraabdominal pressure on postoperative state of respiratory system after surgery for abdominal wall hernia (AWH) was analyzed. The investigation was conducted in 2013-2014 yrs in 35 patients. Perioperative state of pulmonary mechanics, the gas exchange, and the indices of a spirogram were analyzed. The postoperative period course, the rate of the respiratory insufficiency occurrence were analyzed. Respiratory insufficiency was observed, as a rule, in 24 - 48 h after hernioplasty. The AWH plasty lead to the intraabdominal pressure raising, the PaCO2-EtCO2 gradient changes, and the PaO2/FiO2 ratio as well...
October 2015: Klinichna Khirurhiia
Xiaoyan Wu, Ruiqiang Zheng, Hua Lin, Zhiqing Zhuang, Min Zhang, Peixia Yan
OBJECTIVE: To assess the effect of mehanical ventilation (MV) guided by transpulmonary pressure (Ptp) on respiratory mechanics and gas exchange in severe acute pancreatitis patient with intraabdominal hypertension. METHODS: Twelve severe acute pancreatitis patient with intraabdominal hypertension and acute respiratory distress syndrome(ARDS) underwent mechanical ventilation were involved from Jan to Dec 2013. PEEP levels were set to achieve a Ptp of 0 to 10 cm of water at end expiration...
October 20, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Fernando Dip, David Nguyen, Morris Sasson, Emanuele Lo Menzo, Samuel Szomstein, Raul Rosenthal
BACKGROUND: Measurements of optic nerve sheath diameter (ONSD) with noninvasive ocular ultrasonography have been shown to be accurate in determining increased intracranial pressure. Obesity is associated with chronic increases in intraabdominal pressure that could consequently result in intracranial hypertension. By utilizing ONSD ultrasonographic measurements, we compare the difference that may exist between obese and non-obese patients. STUDY DESIGN: We prospectively collected data from patients who underwent laparoscopic procedures in the supine position between July 2013 and March 2014...
June 2016: Surgical Endoscopy
Job Kuteesa, Olivia Kituuka, Dan Namuguzi, Cynthia Ndikuno, Samuel Kirunda, David Mukunya, Moses Galukande
BACKGROUND: Intra-abdominal hypertension (IAH) is defined as a sustained elevation in intra-abdominal pressure (IAP) greater than or equal to 12 mmHg. IAH has been shown to cause organ derangements and dysfunction in the body. Objective screening of IAH is neither done early enough nor at all thus leading to significant morbidity and mortality among surgical patients. The epidemiology and outcome of IAH among surgical patients has not been documented in Uganda. The aim of this study was to determine the prevalence, incidence and outcome of intra-abdominal hypertension among patients undergoing emergency laparotomy...
2015: World Journal of Emergency Surgery: WJES
Lee Feddy, Julian Barker, Pete Fawcett, Ignacio Malagon
BACKGROUND: Severe acute pancreatitis is associated with sever multiorgan failure from 15 to 50%, depending on the series. In some of these patients, conventional methods of ventilation and respiratory support will fail, demanding the use of extracorporeal membrane oxygenation (ECMO). Abdominal compartment syndrome is potentially harmful in this cohort of patients. We describe the successful treatment of three patients with severe acute pancreatitis who underwent respiratory ECMO and where intra abdominal pressure was monitored regularly...
2016: Anaesthesiology Intensive Therapy
Aikaterini Leventi, Eriphylli Argyra, Alexandra Avraamidou, Athanasios Marinis, Spyridon Asonitis, Despoina Perrea, Dionysios Voros, Kassiani Theodoraki
PURPOSE: Increased intra-abdominal pressure, as used in laparoscopic surgery or seen in intraabdominal hypertension (IAH), is associated with tissue ischemia and oxidative stress. Ischemic preconditioning (IP) is a method successfully used in liver and transplant surgery, in order to attenuate the detrimental effects of ischemia and reperfusion. In this experimental study, we tested the ability of IP to modify oxidative stress induced by extremely high intraabdominal pressures. METHODS: Twenty-five female pigs were studied and divided in three groups: a control group, a pneumoperitoneum group (with pressure of 30 mmHg), and an ischemic preconditioning group (initially subjected to preconditioning with pressure of 25 mmHg for 15 min and desufflation for 15 min and then to pneumoperitoneum as in pneumoperitoneum group)...
2015: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Ali Gurel
Organ dysfunctions caused by intraabdominal hypertension is named as abdominal compartment syndrome (ACS). A patient with prostate cancer admitted with dyspnea and oliguria. After decompression his health status improved. For patients with malignant disorders presented with oliguria and respiratory problems who have abdominal distension, ACS should be in mind.
July 2015: Clinical Case Reports
Esther García-Santos, Alejandro Puerto-Puerto, Susana Sánchez-García, Francisco Javier Ruescas-García, Ana Alberca-Páramo, Jesús Martín-Fernández
BACKGROUND: Pneumoperitoneum is defined as the existence of extraluminal air in the abdominal cavity. In 80-90% of cases is due to perforation of a hollow organ. However, in 10-15% of cases, it is nonsurgical pneumoperitoneum. OBJECTIVE: The case of a patient undergoing mechanical ventilation, developing abdominal compartment syndrome tension pneumoperitoneum is reported. CLINICAL CASE: Female, 75 years old asking for advise due to flu of long term duration...
September 2015: Cirugia y Cirujanos
Defei Hong, Jian Cheng, Zhifei Wang, Guoliang Shen, Zhijie Xie, Weiding Wu, Yuhua Zhang, Yuanbiao Zhang, Xiaolong Liu
OBJECTIVE: Our research was conducted to analyze the outcomes of two laparoscopic splenectomy plus pericardial devascularization (LSPD) techniques in the management of portal hypertension (PTH) and hypersplenism. METHODS: Between May 2012 and May 2013, 41 patients with PTH and hypersplenism undergoing LSPD were retrospectively analyzed. Of them, 29 patients received LSPD by LigaSure Vessel Sealing System (LVSS) and Endo-GIA universal endoscopic vascular linear staplers (Endo-GIA) (EG Group) and 12 patients received LSPD by LVSS and Hem-o-Lock (HL Group)...
December 2015: Surgical Endoscopy
E Divarci, B Karapinar, M Yalaz, O Ergun, A Celik
PURPOSE: Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are associated with high mortality rates in children (40-60%). However, literature lacks comprehensive series in childhood. In this study, we aimed to determine the incidences of IAH and ACS, to identify high risk disorders for the development of IAH/ACS and to decrease ACS-associated mortality by early diagnosis and timely intervention. METHODS: A prospective study was performed between December 2009 and October 2010 in our institution...
March 2016: Journal of Pediatric Surgery
Ozden O Horoz, Dincer Yildizdas, Nazik Asilioglu, Tanil Kendirli, Nilgun Erkek, Ayse Berna Anil, Benan Bayrakci, Tolga Koroglu, Basak Nur Akyildiz, Ali Ertug Arslankoylu, Oguz Dursun, Selman Kesici, Esra Sevketoglu, Ilker Unal
PURPOSE: To investigate admission prevalence of intraabdominal hypertension (IAH) and to determine clinical and laboratory characteristics on admission day associated with IAH in critically ill pediatric patients. MATERIALS AND METHODS: One hundred thirty newly admitted critically ill pediatric patients were included. Intra-abdominal pressure (IAP) was measured 4 times (every 6 hours) with the bladder pressure method. Data included the demographics, diagnostic category, pediatric logistic organ dysfunction score and pediatric risk of mortality score II, clinical concomitant factors, and conditions potentially associated with increased intra-abdominal pressure...
June 2015: Journal of Critical Care
I A Kryvoruchko, Iu V Ivanova, M S Povelichenko, S A Andreieshchev
Investigations were conducted in 53 patients, operated on in 2013 yr for abdominal sepsis (AS). The patients state severity was determined in accordance to the systemic inflammatory reaction and the polyorgan insufficiency severity. In 28 patients (group I) AS was diagnosed, in 14 (group II)--severe AS, in 11 (group III)--a septic shock. Tactics of surgical management of the patients have included two main measures: the infection origin control (source control), and control of the affected organ function and systemic defense mechanisms (damage control)...
May 2014: Klinichna Khirurhiia
Dushyant Iyer, Scott D'Amours, Anders Aneman
OBJECTIVE: To investigate screening variables identifying patients at risk of developing intra-abdominal hypertension (IAH) after cardiac surgery. DESIGN AND SETTING: Prospective observational study in a tertiary general intensive care unit. PARTICIPANTS: One hundred and eight patients admitted to the ICU after cardiac surgery, with measurements of intraabdominal pressure (IAP). MAIN OUTCOME MEASURES: Routinely collected clinical, physiological and biochemical variables were analysed with at least twice-daily measurements of IAP during the postoperative stay in the ICU...
September 2014: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
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