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Intraabdominal pressure

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https://www.readbyqxmd.com/read/28618765/the-influence-of-intraabdominal-pressure-on-the-mortality-rate-of-patients-with-acute-pancreatitis
#1
Petar Svorcan, Maja Stojanovic, Predrag Stevanovic, Aleksadar Karamarkovic, Radmilo Jankovic, Nebojsa Ladjevic
BACKGROUND/AIM: Intraabdominal hypertension (IAH) is a common clinical finding in patients with acute pancreatitis and is associated with poor prognosis. This study aimed to determine the impact of intraabdominal pressure (IAP) on the mortality rate in patients with acute pancreatitis in an intensive care unit. MATERIALS AND METHODS: A total of 50 patients with acute pancreatitis were included in this prospective cohort study. Based on the obtained values of IAP, the patients were divided into two groups: those with normal IAP (n = 14) and increased IAP (n = 36)...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28555442/-the-treatment-of-acute-secondary-peritonitis-a-retrospective-analysis-of-the-use-of-continuous-negative-pressure-therapy
#2
V Müller, G Koplin, J Pratschke, W Raue
BACKGROUND: Patients with acute secondary peritonitis often need relaparotomies and open abdominal lavages. Continuous negative pressure therapy seems to be beneficial. OBJECTIVES: Does the efficacy of the therapy depend on the continuous negative pressure system used? MATERIALS AND METHODS: A retrospective analysis was performed in the Chirurgische Klinik der Universitätsmedizin Berlin, Charité Campus Mitte, including all patients who underwent abdominal vacuum therapy between December 2013 and February 2015...
May 29, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28552090/deep-neuromuscular-blockade-and-low-insufflation-pressure-during-laparoscopic-hysterectomy
#3
Matias Vested Madsen, Olav Istre, Henrik Halvor Springborg, Anne Kathrine Staehr-Rye, Jacob Rosenberg, Jørgen Lund, Mona Ring Gätke
INTRODUCTION: Establishment of sufficient muscle relaxation is essential in laparoscopic surgery. During laparoscopy, surgeons can experience abdominal contractions in their patients. Deep neuromuscular block (NMB) has the potential to prevent such episodes. In this study, we explored if deep NMB reduces the incidence of sudden abdominal contractions as compared with standard NMB. METHODS: This was a pre-planned secondary analysis of a randomized, controlled study...
May 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28526462/-sudden-motor-and-sensorial-loss-due-to-retroperitoneal-hematoma-during-postoperative-periods-a-case-report
#4
Pelin Şen, Havva Gül Gültekin, İsmail Caymaz, Ömer Özel, Ayda Türköz
A 68 year-old male patient was hospitalized for radical prostatectomy. He had no abnormal medical history including neurological deficit before the operation. Prior to general anesthesia, an epidural catheter was inserted in the L3-4 interspace for intraoperative and postoperative analgesia. After surgery for nine hours, he developed confusion and flaccid paralysis of bilateral lower extremities occurred. No pathology was detected from cranial computed tomography and diffusion magnetic resonance imaging no pathology was detected...
May 16, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28501286/the-correlation-between-stabbing-related-upper-extremity-wounds-and-survival-of-stabbing-victims-with-abdominal-and-thoracic-injuries
#5
Michael Rozenfeld, Kobi Peleg, Adi Givon, Boris Kessel
BACKGROUND: When treating patients with stab injuries of the torso, clinicians often lack timely information about the degree and nature of internal organ damage. An externally observable sign significantly associated with characteristics of torso injuries may therefore be useful for practitioners. One such potential sign is the presence of wounds to the hands, sometimes sustained during victims' attempt to defend themselves during the violent altercation. Thus, the primary aim of this study was to evaluate the association between presence of upper extremity wounds and the severity of the thoracic and intra-abdominal injuries due to stabbing...
May 1, 2017: Injury
https://www.readbyqxmd.com/read/28357467/-ulcers-in-obesity-associated-chronic-venous-insufficiency
#6
L Scholl, M Dörler, M Stücker
BACKGROUND: Chronic venous insufficiency is a frequently occurring disease consisting of a characteristic symptom complex and ulcerations. Normally, varicose veins with reflux or obstruction can be found. However, these symptoms have also been described in obese people and are considered functional chronic venous insufficiency. The aim of this work was to present patients with ulceration in obesity-associated chronic venous insufficiency and to describe typical features of ulceration in obese people...
March 29, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28330440/prevalence-and-predictors-of-intra-abdominal-hypertension-and-compartment-syndrome-in-surgical-patients-in-critical-care-units-at-kenyatta-national-hospital
#7
A Muturi, P Ndaguatha, Daniel Ojuka, A Kibet
BACKGROUND: Intra-abdominal hypertension (IAH) affects almost every organ sytem.If it is not detected early and corrected, mortality would be high. The prevalence of IAH and abdominal compartment syndrome (ACS) at Kenyatta National Hospital (KNH) critical care units is not known. The aim of this sudy was to determine the prevalence and factors associated with development of IAH/ACS among critically ill surgical patients. METHODS: This was a cross sectional descriptive study involving surgical patients in critical care units at KNH, carried out from March 2015 to October 2015...
March 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28287013/a-different-technique-in-gasless-laparoendoscopic-single-site-hysterectomy
#8
Gökhan Demirayak
The aim of this study was to show a different technique for a gasless laparoendoscopic single-site (LESS) hysterectomy and to present advantages and limitations of this technique. Women undergoing gasless LESS hysterectomy with a different technique were evaluated. A total of 14 LESS hysterectomies were performed using this gasless technique and rigid laparoscopic instruments by one surgeon. The mean age of the patients was 48.6 (±4.6). The average blood loss was 80 ± 35 ml. The average time between an umbilical incision and starting hysterectomy was 5 (±2,1) min...
March 13, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28285427/association-between-intraabdominal-pressure-during-gynaecologic-laparoscopy-and-postoperative-pain
#9
Sudip Kundu, Clara Weiss, Hermann Hertel, Peter Hillemanns, Rüdiger Klapdor, Philipp Soergel
PURPOSE: Laparoscopy is nowadays a well-established surgical method and plays a main role in an ever-increasing range of indications in gynaecology. High-quality studies of surgical techniques are necessary to improve the quality of patient care. The present study aims at evaluating postoperative pain after gynaecological laparoscopy depending on the intraoperative CO2 pressure. METHODS: In a prospective, monocentric, randomized single-blind study at the Department of Gynaecology and Obstetrics at the Hannover Medical School, we include patients scheduled for different laparoscopic procedures...
March 11, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28235528/effects-of-pneumoperitoneum-on-severe-hypernatremia-in-an-adult-patient-who-underwent-laparoscopic-surgery-of-hydatid-cysts
#10
Diego Anta, José M Beleña, Raquel Álvarez, Mónica Núñez
We describe the first case of severe hypernatremia associated to laparoscopic surgery for hydatid cyst in an adult patient after the use of hypertonic saline solution with complete resolution. Severe hypernatremia is an unusual fact at the immediate postoperative period but may have fatal consequences for the patient and need immediate action. The patient reached a serum sodium concentration of 179 mmol/L without adverse effects after 6 days of treatment. Laparoscopy could play a crucial role in Na(+) absorption due to high intraabdominal pressure caused by the pneumoperitoneum and its limitations to avoid peritoneal absorption of hypertonic saline solution...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28193800/cardiovascular-and-ventilatory-consequences-of-laparoscopic-surgery
#11
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
https://www.readbyqxmd.com/read/28073188/effects-of-obesity-surgery-laparoscopic-sleeve-gastrectomy-technique-on-lower-urinary-tract-symptoms-depression-and-quality-of-life-of-males-prospective-study
#12
Fatih Uruç, Serkan Akan, Bekir Aras, Çaglar Yıldırım, Aytaç Sahin, Ozgur Haki Yuksel, Mehmet Timuçin Aydın, Ayhan Verit
PURPOSE: Technically, obesity weakens the pelvic base muscles by causing an increase in the intraabdominal pressure and intravesical pressure due to increasing fat and it triggers the occurrence of lower urinary tract symptoms. However it is believed that weight loss will cause recovery of these symptoms. Our purpose in this study is to research about the effects of the weight loss achieved by using especially the Laparoscopic Sleeve Gastrectomy (LSG) technique of bariatric surgery which is being more and more widely used today...
December 30, 2016: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/27995452/an-optimal-approach-for-laparoscopic-d3-lymphadenectomy-plus-complete-mesocolic-excision-d3-cme-for-right-sided-colon-cancer
#13
Daxing Xie, Chaoran Yu, Chun Gao, Hasan Osaiweran, Junbo Hu, Jianping Gong
BACKGROUND: It is common knowledge that high ligation of blood vessels at the D3 level and complete mesocolic excision (CME) are two critical points of right hemicolectomy for right colon cancer (RCC). (1-5) To date, a safe strategy for completing these two procedures under laparoscopic surgery has not been extensively described. The authors provide a video to demonstrate laparoscopic right hemicolectomy (D3 + CME) with an optimal mesentery-defined approach. By identifying three "tri-junctions," this approach facilitates dissection of the entire mesocolon along the embryologic planes as far centrally as possible and enables the high tie of feeding vessels at bifurcation...
May 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27966324/the-effect-of-pneumoperitoneum-on-intravascular-fibrinolytic-activity-in-rats
#14
Kürşat Dikmen, Asiye Uğraş Dikmen, Hasan Bostancı, Ahmet Karamercan, Münci Yağcı, Murat Akın, Bülent Aytaç
BACKGROUND/AIM: Venous stasis during pneumoperitoneum in laparoscopic surgery is closely related to fibrin synthesis and deposition. The etiologic factors underlying fibrinolysis or hypercoagulability are not clearly defined. This study aimed to determine the effects of pneumoperitoneum time and pressure on coagulation cascade and the fibrinolytic pathway. MATERIALS AND METHODS: After the pneumoperitoneum model was established in rats, PAI-1, tPA, TAFI, D-dimer, and fibrinogen activities were evaluated in different time periods under different pressures in groups including 6 rats...
November 17, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27830178/diaphragmatic-hernia-after-living-donor-right-hepatectomy-proposal-for-a-screening-protocol
#15
Scott M Livingstone, Axel Andres, A M James Shapiro, Norman N Kneteman, David L Bigam
BACKGROUND: Living donor hepatectomy (LDH) is increasingly being used to improve access to liver transplantation for those with end-stage liver disease. Although recipient outcomes are equivalent, donor complication rates range from 10% to 41%. A rare, but potentially serious complication is occurrence of a diaphragmatic hernia (DH), of which 9 cases have been reported so far in the literature. The purpose of this work was to review the clinical impact of DH post-LDH, including risk factors (RF) in hope of mitigating impact...
July 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27826465/collagenopathies-implications-for-abdominal-wall-reconstruction-a-systematic-review
#16
Bridget Harrison, Kyle Sanniec, Jeffrey E Janis
BACKGROUND: The etiology of hernia formation is strongly debated and includes mechanical strain, prior surgical intervention, abnormal embryologic development, and increased intraabdominal pressure. Although the most common inciting cause in ventral hernias is previous abdominal surgery, many other factors contribute. We explore this etiology through an examination of the current literature and existing evidence on patients with collagen vascular diseases, such as Ehlers-Danlos syndrome...
October 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27810147/outcomes-in-pediatric-patients-with-abdominal-compartment-syndrome-following-urgent-exploratory-laparotomy
#17
S Thomas, D Kriplani, C Crane, S O Dehom, G Oei, J Baerg, C Wright, Y Xu, J C Ejike
BACKGROUND/PURPOSE: Abdominal compartment syndrome (ACS) is a serious condition with high mortality in critically ill children. Our objectives were to characterize the incidence of ACS in pediatric patients who underwent urgent exploratory laparotomy and to compare outcomes of patients with and without ACS. METHODS: This retrospective review examined pediatric patients (0-18years) who underwent urgent exploratory laparotomy over a 2-year period. Primary outcome was mortality; secondary outcomes were achievement of primary fascial closure and necessity of bowel resection...
October 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27767980/hemorheological-factors-can-be-informative-in-comparing-treatment-possibilities-of%C3%A2-abdominal-compartment-syndrome
#18
Norbert Nemeth, Katalin Peto, Adam Deak, Viktoria Sogor, Gabor Varga, Bence Tanczos, Klaudia Balog, Adrienn Csiszko, Zoltan Godo, Zsolt Szentkereszty
BACKGROUND: Abdominal compartment syndrome (ACS) is a life-threatening condition, of which pathomechanism hasn't been completely clarified, yet. Furthermore, surgical therapy still needs optimization. OBJECTIVE: We aimed to investigate microcirculatory and micro-rheological alterations in ACS, using various temporary abdominal closure methods, including three settings of vacuum-assisted closure technique (negative pressure wound therapy, NPWT). METHODS: On anesthetized pigs, by intraabdominally placed and filled-up silicone bags, intraabdominal pressure at 30 mmHg was maintained for 3 hours, and afterwards, decompressive laparotomy happened...
2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27727026/best-practice-for-perioperative-management-of-patients-with-cytoreductive-surgery-and-hipec
#19
REVIEW
C Raspé, L Flöther, R Schneider, M Bucher, P Piso
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures...
September 28, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27687373/effect-of-depth-of-neuromuscular-blockade-on-the-abdominal-space-during-pneumoperitoneum-establishment-in-laparoscopic-surgery
#20
Javier Barrio, Carlos L Errando, Guillermo San Miguel, Boris I Salas, Juan Raga, José L Carrión, Jaime García-Ramón, Juan Gallego
STUDY OBJECTIVE: To evaluate the effect of neuromuscular blockade (NMB) upon the abdominal space during pneumoperitoneum establishment in laparoscopic surgery, comparing moderate NMB and deep NMB. DESIGN: Prospective, randomized, crossover clinical trial. SETTING: Operating room. PATIENTS: Seventy-six American Society of Anesthesiologists 1 to 2 patients scheduled for elective laparoscopic surgery. INTERVENTIONS: Two independent evaluations were performed at the establishment of pneumoperitoneum for a preset intraabdominal pressures (IAPs) of 8 and 12 mm Hg, both during moderate NMB (train-of-four count, 1-3) and deep NMB (posttetanic count, <5)...
November 2016: Journal of Clinical Anesthesia
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