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Intraabdominal pressure

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...
October 20, 2016: Clinical Hemorheology and Microcirculation
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
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
Jaime Ruiz-Tovar, Carolina Llavero
Obesity itself is associated with an increased risk of thromboembolic events. Moreover, most bariatric procedures actually are performed by laparoscopic approach, implying an increased intraabdominal pressure during the surgical procedure that may favor the development of thrombus. Therefore, bariatric surgery is considered a high-risk procedure for thromboembolic events. Actual recommendations are to include low molecular weight heparins (LMWH) and compression stockings in the primary prophylaxis of thromboembolic events...
September 15, 2016: Advances in Experimental Medicine and Biology
Stephen C Haskins, Natasha A Desai, Kara G Fields, Jemiel A Nejim, Stephanie Cheng, Struan H Coleman, Danyal H Nawabi, Bryan T Kelly
BACKGROUND: Intraabdominal fluid extravasation (IAFE) after hip arthroscopy has historically been diagnosed in catastrophic circumstances with abdominal compartment syndrome requiring diuresis or surgical decompression. A previous retrospective study found the prevalence of symptomatic IAFE requiring diuresis or decompression to be 0.16%, with risk factors including surgical procedure and high pump pressures. IAFE can be diagnosed rapidly by using point-of-care ultrasound (POCUS) via the Focused Assessment With Sonography for Trauma (FAST) examination, which is a well-established means to detect free fluid with high specificity and sensitivity...
August 22, 2016: Anesthesia and Analgesia
R Simón-Allué, B Hernández-Gascón, L Lèoty, J M Bellón, E Peña, B Calvo
BACKGROUND: Hernia repairs still exhibit clinical complications, i.e. recurrence, discomfort and pain and mesh features are thought to be highly influent. The aim of this study is to evaluate the impact of the defect size and mesh type in an herniated abdominal wall using numerical models. METHODS: To do so, we have started from a FE model based on a real human abdomen geometry obtained by MRI, where we have provoked an incisional hernia of three different sizes...
August 22, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Michael E Egger, Vijaya Gottumukkala, Jonathan J Wilks, Jose Soliz, Matthias Ilmer, Jean Nicolas Vauthey, Claudius Conrad
We enumerate the broad range of anesthetic considerations that affect the outcome of patients undergoing laparoscopic liver resection. Key elements for excellent outcomes after laparoscopic liver resection are careful patient selection and risk stratification, appropriate monitoring, techniques to reduce blood loss and transfusion, and active recovery management. Although some of these key elements are the same for open liver operation, there are specific anesthetic considerations of which both the surgical and anesthesia teams must be aware to achieve optimal patient outcomes after laparoscopic liver resection...
August 18, 2016: Surgery
Hüseyin Ulaş Pınar, Rafi Doğan, Ümmü Mine Konuk, Egemen Çifci, Enes Duman, Erdal Karagülle, Emin Türk, Ömer Karaca
BACKGROUND: Increased central venous pressure secondary to an increase in intraabdominal pressure has been reported during laparoscopic surgery. However, no study has yet determined the effect of pneumoperitoneum on cross-sectional area (CSA) of central veins by ultrasonography during laparoscopic cholecystectomy. Herein, we aimed to quantify changes in CSAs of internal jugular (IJV) and subclavian veins (SCV) by ultrasonography during this surgery. METHODS: This study included 60 ASA I-II patients scheduled for laparoscopic cholecystectomy surgery under general anesthesia...
2016: BMC Anesthesiology
D S Vasyhlchenko, V I Desyateryk, S O Sheyko, T I Zverevych
Results of examination and surgical tratment of 56 patients, suffering chronic calculous cholecystitis with concomitant schemic heart disease, were analyzed. In all the patients a laparoscopic cholecystectomy was performed. Monitoring of cardiovascular compli- cations was estimated with the help of a Helter recording of EGG intraoperatively and in the early postoperative period. Depending on a kind of preoperative preparation done, the patients were divided on two groups: those, to whom cardioprotection using a Vasopro preparation was conducted, and those without cardioprotection...
March 2016: Klinichna Khirurhiia
Hüsnü Mert Arinalp, Nurten Bakan, Gülşah Karaören, Ömer Torun Şahin, Emre Çeliksoy
BACKGROUND/AIM: In laparoscopic procedures, intraabdominal carbon dioxide (CO2) insufflation can cause decreased compliance, increased airway resistance, and impaired ventilation-perfusion ratios. We aimed to investigate the effects of intraoperative positive end-expiratory pressure (PEEP) treatment on respiratory dynamics and elimination time of volatile anesthetic agents. MATERIALS AND METHODS: In the present study, 75 ASA I-II patients were randomized into 3 groups to receive 0 cmH2O PEEP (group I), 5 cmH2O PEEP (group II), or 8 cmH2O PEEP (group III)...
2016: Turkish Journal of Medical Sciences
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
Julio C U Coelho, Christiano M P Claus, Antonio C L Campos, Marco A R Costa, Caroline Blum
Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to enlarge rapidly and to complicate. The treatment of umbilical hernia in these patients is a surgical challenge. Ascites control is the mainstay to reduce hernia recurrence and postoperative complications, such as wound infection, evisceration, ascites drainage, and peritonitis. Intermittent paracentesis, temporary peritoneal dialysis catheter or transjugular intrahepatic portosystemic shunt may be necessary to control ascites...
July 27, 2016: World Journal of Gastrointestinal Surgery
P Novák, V Vacek, R Vondráková
INTRODUCTION: Primary omental torsion is a rare finding in cases of suspected acute abdomen. It is more common in children. Secondary omental torsion is typical for adults. CASE REPORT: The authors describe two cases where pain in the right upper abdominal quadrant was caused by primary torsion of the omental corner due to increased intraabdominal pressure: after a strong cough in one girl and after a workout in the other. Primary omental torsion usually mimics acute appendicitis with clinical findings in the right lower abdominal quadrant, especially in obese children...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Steffen Wirth, Andreas Biesemann, Johannes Spaeth, Stefan Schumann
BACKGROUND: Pneumoperitoneum during laparoscopic surgery leads to atelectasis and impairment of oxygenation. Positive end-expiratory pressure (PEEP) is supposed to counteract atelectasis. We hypothesized that the derecruiting effects of pneumoperitoneum would deteriorate the intratidal compliance profile in patients undergoing laparoscopic surgery. METHODS: In 30 adult patients scheduled for surgery with pneumoperitoneum, respiratory variables were measured during mechanical ventilation...
June 20, 2016: Surgical Endoscopy
O M Pavlova
Postoperative respiratory disorders after prosthesis for the anterior abdominal wall hernia and their predictors were analyzed in 37 patients. Hypoxemic respiratory disorders were revealed in 59% patients. Speciphic predictors for the respiratory disorders occurrence after prosthesis for the anterior abdominal wall hernia were determined: obesity, syndrome of obstructive sleep apnoe, intraabdominal pressure raising to more than 16 cm of a water column immediately after the prosthesis. The prosthesis duration have constituted more than 3 yrs...
February 2016: Klinichna Khirurhiia
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]...
May 13, 2016: Surgical Endoscopy
O Toumi, F Noomen, R Salem, H Rabeh, S B Jabra, I Korbi, S Bannani, M Nasr, K Zouari, G Mondher, A Hamdi
PURPOSE: Hydatid cyst rupture into abdominal cavity is a rare but a serious complication. The rupture can occur after a trauma, or spontaneously as a result of increased intracystic pressure. It is a surgical emergency with high morbidity and mortality rates. Early diagnosis and appropriate surgical management of this complication can be life saving. The objective of the current paper is to evaluate the clinical, and radiographic findings and surgical treatment of this complication. METHODS: A retrospective study on 12 patients operated in our department for intraperitoneal rupture of hydatid cyst between January 1990 and May 2015...
March 23, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Doğan Alhan, İsmail Şahin, Serbülent Güzey, Andaç Aykan, Fatih Zor, Serdar Öztürk, Mustafa Nışancı, İsmail Hakkı Özerhan
BACKGROUND: Open abdomen is a salvage procedure that prevents catastrophes after severe intraabdominal traumas. However, following this life saving attempt, it is mostly not feasible to close the abdomen immediately after the recovery of intraabdominal injuries. Consequently, a staged reconstruction is required, and the first stage is usually a temporary closing approach. At the end of this stage, resulting giant "ventral hernia" is a burden for both the patient and the surgeon. Therefore a permanent repair is subsequently needed...
December 2015: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Devrim Aksakal, Thomas Hückstädt, Steffen Richter, Daniela Klitscher, Tobias Wowra, Felix Schier, Lucas M Wessel, Rainer Kubiak
BACKGROUND: Our previous work in a laparoscopic setting in piglets revealed that the systolic femoral artery pressure was approximately 5 % higher than its carotid counterpart, whereas the mean and diastolic values showed no significant difference. This remained idem when the intraabdominal pressure (IAP) was gradually increased. In this study, we aimed to investigate the effect of (1) intermittent IAP elevations and (2) a low cardiac output (CO) on the blood pressure (BP) difference cranially (carotid artery) and caudally (femoral artery) of a capnoperitoneum (ΔP = P a fem-P a carot)...
March 16, 2016: Surgical Endoscopy
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
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