scholarly journals Stable Gastric Pentadecapeptide BPC 157 Therapy for Primary Abdominal Compartment Syndrome in Rats

2021 ◽  
Vol 12 ◽  
Author(s):  
Marijan Tepes ◽  
Slaven Gojkovic ◽  
Ivan Krezic ◽  
Helena Zizek ◽  
Hrvoje Vranes ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Azygos Vein ◽  
Abdominal Pressure ◽  
Bpc 157 ◽  
Anesthetized Rats ◽  
Abdominal Hypertension ◽  
Major Vessel ◽  
Pentadecapeptide Bpc 157 ◽  
Abdominal Compartment

Recently, the stable gastric pentadecapeptide BPC 157 was shown to counteract major vessel occlusion syndromes, i.e., peripheral and/or central occlusion, while activating particular collateral pathways. We induced abdominal compartment syndrome (intra-abdominal pressure in thiopental-anesthetized rats at 25 mmHg (60 min), 30 mmHg (30 min), 40 mmHg (30 min), and 50 mmHg (15 min) and in esketamine-anesthetized rats (25 mmHg for 120 min)) as a model of multiple occlusion syndrome. By improving the function of the venous system with BPC 157, we reversed the chain of harmful events. Rats with intra-abdominal hypertension (grade III, grade IV) received BPC 157 (10 µg or 10 ng/kg sc) or saline (5 ml) after 10 min. BPC 157 administration recovered the azygos vein via the inferior–superior caval vein rescue pathway. Additionally, intracranial (superior sagittal sinus), portal, and caval hypertension and aortal hypotension were reduced, as were the grossly congested stomach and major hemorrhagic lesions, brain swelling, venous and arterial thrombosis, congested inferior caval and superior mesenteric veins, and collapsed azygos vein; thus, the failed collateral pathway was fully recovered. Severe ECG disturbances (i.e., severe bradycardia and ST-elevation until asystole) were also reversed. Microscopically, transmural hyperemia of the gastrointestinal tract, intestinal mucosa villi reduction, crypt reduction with focal denudation of superficial epithelia, and large bowel dilatation were all inhibited. In the liver, BPC 157 reduced congestion and severe sinusoid enlargement. In the lung, a normal presentation was observed, with no alveolar membrane focal thickening and no lung congestion or edema, and severe intra-alveolar hemorrhage was absent. Moreover, severe heart congestion, subendocardial infarction, renal hemorrhage, brain edema, hemorrhage, and neural damage were prevented. In conclusion, BPC 157 cured primary abdominal compartment syndrome.

scholarly journals Abdominal compartment syndrome in severe acute pancreatitis (review of literature)

2020 ◽  
Vol 179 (2) ◽  
pp. 73-78
Author(s):  
L. A. Otdelnov ◽  
A. S. Mukhin
Keyword(s):  
Acute Pancreatitis ◽  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Severe Acute Pancreatitis ◽  
Medical Management ◽  
Abdominal Pressure ◽  
Decompressive Laparotomy ◽  
Russian Science Citation Index ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

The study was performed for analysis of current understanding of intra-abdominal hypertension and abdominal compartment syndrome in patients with severe acute pancreatitis.The English and Russian articles about intra-abdominal hypertension and abdominal compartment syndrome in patients with severe acute pancreatitis were analyzed. The articles were found in «Russian Science Citation Index» and «PubMed».There is a pathogenetic relationship between increased intra-abdominal pressure and the development of severe acute pancreatitis.For today, it was shown that intra-abdominal hypertension in patients with severe acute pancreatitis is associated with significantly higher APACHE-II and MODS score, prevalence of pancreatic and peripancreatic tissue lesions, early infection of pancreatic necrosis and higher mortality.The article considers various variants of decompressive interventions such as decompressive laparotomy, fasciotomy and percutaneous catheter drainage. For today, there are no randomized studies devoted to researching effectiveness of different decompressive interventions.The study showed that it is necessary to regularly monitor intra-abdominal pressure in patients with severe acute pancreatitis. Patients with intra-abdominal hypertension require emergency medical management to reduce intra-abdominal pressure. Inefficiency of the medical management and development of abdominal compartment syndrome are indications for surgery. The effectiveness of different decompressive interventions requires further studies.

Pathophysiology and Management of Abdominal Compartment Syndrome

2003 ◽  
Vol 12 (4) ◽  
pp. 367-371 ◽  
Author(s):  
Jeffrey Walker ◽  
Laura M. Criddle
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Oxygen Free Radicals ◽  
Abdominal Pressure ◽  
Decompressive Laparotomy ◽  
Abdominal Hypertension ◽  
Translocation Of Bacteria ◽  
Serial Measurements ◽  
Abdominal Compartment ◽  
Multiorgan Dysfunction Syndrome

Abdominal compartment syndrome is a potentially lethal condition caused by any event that produces intra-abdominal hypertension; the most common cause is blunt abdominal trauma. Increasing intra-abdominal pressure causes progressive hypoperfusion and ischemia of the intestines and other peritoneal and retroperitoneal structures. Pathophysiological effects include release of cytokines, formation of oxygen free radicals, and decreased cellular production of adenosine triphosphate. These processes may lead to translocation of bacteria from the gut and intestinal edema, predisposing patients to multiorgan dysfunction syndrome. The consequences of abdominal compartment syndrome are profound and affect many vital body systems. Hemodynamic, respiratory, renal, and neurological abnormalities are hallmarks of abdominal compartment syndrome. Medical management consists of urgent decompressive laparotomy. Nursing care involves vigilant monitoring for early detection, including serial measurements of intra-abdominal pressure.

scholarly journals Abdominal Compartment Syndrome as a Multidisciplinary Challenge. A Literature Review

2018 ◽  
Vol 4 (4) ◽  
pp. 114-119 ◽  
Author(s):  
Gabriel Alexandru Popescu ◽  
Tivadar Bara ◽  
Paul Rad
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Treatment Guidelines ◽  
Surgical Care ◽  
Abdominal Pressure ◽  
Decompressive Laparotomy ◽  
Abdominal Hypertension ◽  
Treatment Measures ◽  
Points Of View ◽  
Abdominal Compartment

Abstract Abdominal Compartment Syndrome (ACS), despite recent advances in medical and surgical care, is a significant cause of mortality. The purpose of this review is to present the main diagnostic and therapeutic aspects from the anesthetical and surgical points of view. Intra-abdominal hypertension may be diagnosed by measuring intra-abdominal pressure and indirectly by imaging and radiological means. Early detection of ACS is a key element in the ACS therapy. Without treatment, more than 90% of cases lead to death and according with the last reports, despite all treatment measures, the mortality rate is reported as being between 25 and 75%. There are conflicting reports as to the importance of a conservative therapy approach, although such an approach is the central to treatment guidelines of the World Society of Abdominal Compartment Syndrome, Decompressive laparotomy, although a backup solution in ACS therapy, reduces mortality by 16-37%. The open abdomen management has several variants, but negative pressure wound therapy represents the gold standard of surgical treatment.

Incidence of Intra-Abdominal Hypertension and Abdominal Compartment Syndrome: A Systematic Review

2019 ◽  
Vol 36 (2) ◽  
pp. 197-202 ◽  
Author(s):  
Zaid Khot ◽  
Patrick B. Murphy ◽  
Nathalie Sela ◽  
Neil G. Parry ◽  
Kelly Vogt ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Critically Ill ◽  
Abdominal Compartment Syndrome ◽  
Critically Ill Patients ◽  
Data Extraction ◽  
Common Finding ◽  
Abdominal Pressure ◽  
Abdominal Hypertension ◽  
Definition Of ◽  
Abdominal Compartment

Objective: To determine the contemporary prevalence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome in critically ill patients. Data Sources: Medline, Embase, and Central databases. Study Selection: Studies reporting on the prevalence of IAH in consecutively admitted critically ill patients using the World Society of Abdominal Compartment Syndrome (WSACS) consensus guidelines for intra-abdominal pressure (IAP) measurement. Data Extraction: Duplicate independent review and data abstraction. Data Synthesis: The search identified 2428 titles with 6 eligible studies (n = 1965). Reported prevalence ranged from 30% to 49%. Despite abiding by the WSACS guidelines for IAP measurement, studies varied in their definition of IAH, frequency and duration of IAP measurement, and reporting of outcomes. Three of 6 studies reported that IAH, especially at higher grades, was an independent predictor of mortality. Conclusions: Intra-abdominal hypertension is a common finding in critically ill patients and may be associated with increased mortality, especially at higher grades. Further prospective research is required to examine the effect of screening and treatment of IAH on patient outcomes.

Abdominal Compartment Syndrome in Children

2012 ◽  
Vol 32 (6) ◽  
pp. 51-61 ◽  
Author(s):  
Jennifer Newcombe ◽  
Mudit Mathur ◽  
J. Chiaka Ejike
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Care Setting ◽  
Perfusion Pressure ◽  
Abdominal Pressure ◽  
Timely Manner ◽  
Normal Ranges ◽  
Abdominal Hypertension ◽  
Abdominal Compartment ◽  
Instructive Case

Abdominal compartment syndrome is defined as sustained intra-abdominal pressure greater than 20 mm Hg (with or without abdominal perfusion pressure <60 mm Hg) associated with new organ failure or dysfunction. The syndrome is associated with 90% to 100% mortality if not recognized and treated in a timely manner. Nurses are responsible for accurately measuring intra-abdominal pressure in children with abdominal compartment syndrome and for alerting physicians about important changes. This article provides relevant definitions, outlines risk factors for abdominal compartment syndrome developing in children, and discusses an instructive case involving an adolescent with abdominal compartment syndrome. Techniques for measuring intra-abdominal pressure, normal ranges, and the importance of monitoring in the critical care setting for timely identification of intra-abdominal hypertension and abdominal compartment syndrome also are discussed.

scholarly journals Relationship between Sequential Organ Failure Assessment (SOFA) and intra-abdominal pressure in intensive care unit

2014 ◽  
Vol 27 (4) ◽  
pp. 256-260 ◽  
Author(s):  
Gustavo Rocha Costa de FREITAS ◽  
Olival Cirilo Lucena da FONSECA-NETO ◽  
Carla Larissa Fernandes PINHEIRO ◽  
Luiz Clêiner ARAÚJO ◽  
Roberto Esmeraldo Nogueira BARBOSA ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Sequential Organ Failure Assessment ◽  
Compartment Syndrome ◽  
Organ Failure ◽  
Abdominal Compartment Syndrome ◽  
Abdominal Pressure ◽  
Abdominal Hypertension ◽  
Failure Assessment ◽  
Abdominal Compartment

BACKGROUND: Patients in the intensive care unit are at risk of developing intra-abdominal hypertension and abdominal compartment syndrome. AIM: To describe the relation between Sequential Organ Failure Assessment (SOFA) vs. intra-abdominal pressure and the relation between SOFA and risk factors for intra-abdominal hypertension. METHOD: In accordance with the recommendations of the World Society of the Abdominal Compartment Syndrome, the present study measured the intra-abdominal pressure of patients 24 h and 48 h after admission to the unit and calculated the SOFA after 24 h and 48 h. Data was collected over two-month period. RESULTS: No correlation was found between SOFA and intra-abdominal pressure. Seventy percent of the patients were men and the mean age was 44 years, 10% had been referred from general surgery (with a mean intra-abdominal pressure of 11) and 65% from neurosurgery (with a mean intra-abdominal of 6.7). Only three (7.5%) presented with intra-abdominal hypertension. The highest SOFA was 15 and the most frequent kind of organ failure was neurological, with a frequency of 77%. There was a strong correlation between the SOFA after 24 h and 48 h and peak respiratory pressure (ρ=0.43/p=0.01; ρ=0.39/p=0.02). CONCLUSION: No correlation was found between SOFA and intra-abdominal pressure in the patients covered by the present study. However, it is possible in patients undergoing abdominal surgery or those with abdominal sepsis. Não houve correlação entre o SOFA e a pressão intra-abdominal nos pacientes aqui estudados; contudo, sinalizou ser possível em pacientes com operação abdominal ou naqueles com sepse abdominal.

scholarly journals Diagnosis and Choice of a Method of Treatment of Intraabdominal Hypertension and Abdominal Compartment Syndrome

2019 ◽  
Vol 74 (3) ◽  
pp. 210-215
Author(s):  
Vil M. Timerbulatov ◽  
Shamil V. Timerbulatov ◽  
Radik R. Fayazov ◽  
Mahmud V. Timerbulatov ◽  
Elza N. Gaynullina ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Conservative Treatment ◽  
Early Diagnosis ◽  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Severe Acute Pancreatitis ◽  
Abdominal Pressure ◽  
Decompressive Laparotomy ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

BACKGROUND: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) remain a complex problem of abdominal surgery. To date, the pathophysiological mechanisms, methods for determining intra-abdominal pressure (IAP) the frequency of its measurement, and the methods of conservative and surgical more and more researchers consider surgical decompression as a treatment. AIMS: Аnalysis of the results of the implementation of monitoring of intra-abdominal pressure and its impact on the outcomes of treatment of patients with severe acute pancreatitis and acute colon obstruction. MATERIALS AND METHODS: A study of 397 patients with emergency abdominal pathology including 197 with acute obstructive obstruction of the colon (AOOC), 200 severe acute pancreatitis (SAP) was performed. Patients (n=201) were included in the I (main) group, which was carried out using IAP as the main criterion for assessing the patient`s condition and when choosing a method of treatment, in II ― without taking then into account and monitoring. Measurement of IAP, blood lactate was determined primarily, then alternatively 4 to 6 hours. The survey included the study of biochemical indicators, endoscopic methods, visualization (ultrasound scanning, CT of the abdominal cavity organs). RESULTS: In the I group of IAH patients, I and II degrees were in 73.13%, in the II group in 79.5% IAH III and IV degrees, respectively, in 26.87% and 21.5% (p0.05). Measurement of IAP was carried out according to the I.L. Kron method, repeated measurement depending on the degree of IAH after 46 hours, simultaneously, as a predictor of internal ischemia, determined the level of lactate in blood and perfusion abdominal pressure. An algorithm for early diagnosis is suggested excess intraabdominal pressure. For I and II, the degree of IAH was treated with aggressive conservative therapy, with failure of intensive therapy III of IAH degree surgical treatment, with IV degree IAH emergency decompressive laparotomy. In the I group, the mortality was significantly lower than in the II group: IAH at III, with AOOC 27.7% and 50%, respectively (p0.05), at SAP 37.5% and 80% (p0.01), respectively, at IV degree IAH for AOOC 75% and 90% (p0.05), with SAP 75% and 88,8% (p0.05) respectively. CONCLUSIONS: The results of treatment of patients with IAH can be improved by its early diagnosis, intensive, aggressive therapy of IAH IIII degrees. At IAH I, II degrees conservative treatment is shown, persistent aggressive conservative treatment should be performed at IAH III degree, if it is unsuccessful and IV degree of IAH, an emergency decompressive laparotomy should be performed.

scholarly journals Prevention of compartment syndrome after abdominal surgeries

2016 ◽  
Vol 97 (1) ◽  
pp. 84-89
Author(s):  
E K Salakhov ◽  
K K Salakhov
Keyword(s):  
High Risk ◽  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Pathological Condition ◽  
Tissue Perfusion ◽  
Surgical Pathology ◽  
Abdominal Pressure ◽  
Generalized Peritonitis ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

The article presents the basic concepts and definitions of compartment syndrome, some mechanisms of its development, methods of treatment and prevention. Abdominal compartment syndrome is diagnosed in 20% of patients with therapeutic and 30% of patients with surgical pathology. Mortality in its development amid the treatment reaches 42-68%, and without treatment - 100%. The high risk of abdominal compartment syndrome development is characteristic for patients with generalized peritonitis. The trigger mechanism of syndrome development becomes increased intra-abdominal pressure, which leads to the multiple organ failure development. Currently, there are different approaches to the abdominal compartment syndrome prevention. There is no doubt that it is better to prevent this syndrome than cure, as well as any other pathological condition. It is necessary to bear in mind the probability of its formation and routinely measure intra-abdominal pressure in high-risk patients. Treatment tactics choice and timely detection of intra-abdominal hypertension are crucial in prevention of the abdominal compartment syndrome development in patients with abdominal surgical pathology. In general, it is recommended to perform preventive measures in respect of abdominal compartment syndrome in two directions. As the first one, the decision on the type of wound suturing is considered. Tissue perfusion optimization is considered as another preventive direction. Currently, there is no single approach in the abdominal compartment syndrome prevention in patients with generalized peritonitis, and further studies in this area are highly relevant. Since this pathology leads to impairment of almost all vital body functions and is associated with extremely high mortality, its early diagnosis by the intra-abdominal pressure monitoring, which allows to perform timely actions that prevent an adverse outcome, is of particular importance.

Pathophysiology and management of raised intra-abdominal pressure in the critically ill

2016 ◽  
Author(s):  
Inneke E. De laet ◽  
Manu L. N. G. Malbrain
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Treatment Options ◽  
Abdominal Pressure ◽  
Organ Function ◽  
Organ Systems ◽  
Abdominal Hypertension ◽  
The World ◽  
Icu Management ◽  
Abdominal Compartment

The deleterious effects of raised intra-abdominal pressure (IAP) on organ function and mortality have been known for decades, even centuries. Interest in this phenomenon has revived since the 1980s and, recently, the World Society for the Abdominal Compartment Syndrome has published new consensus definitions and guidelines. This chapter will focus on the new definitions for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS), identify risk factors for the development of IAH/ACS, provide guidelines for IAP monitoring (including when to start, how to measure, and when to stop), and discuss both surgical and medical treatment options for both IAH and ACS. The effect of increased IAP on different organ systems is explained and suggestions on how to adjust ICU management of the patient with IAH are offered.

scholarly journals ABDOMINAL COMPARTMENT SYNDROME IN BURN PATIENTS

2018 ◽  
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Fluid Resuscitation ◽  
Burn Injury ◽  
Abdominal Pressure ◽  
Burn Patients ◽  
Severe Burn ◽  
Severe Burns ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are consistently associated with morbidity and mortality among the critically ill or injured. Thus, avoiding or potentially treating these conditions may improve patient outcomes. Despite a large number of special publications devoted to this problem, very little attention is paid to the ACS in patients with severe burn injuries. Severe burns have been shown to be a risk factor for developing IAH. Fluid resuscitation practices used in burns management further predispose patients to increase intra-abdominal pressure. The incidence of intraabdominal hypertension in patients with severe thermal injury is, according to different authors, 57.8–82.6 %. The mortality associated with IAH in severe burns is very high once organ dysfunction occurs. The purpose of this work is to collect and analyze the problem of abdominal hypertension in burn patients, as well as to draw conclusions on the prevention of this condition and improve the results of treatment of patients with severe burn injury. Intra-abdominal hypertension is a frequent complication in severe burn patients requiring massive fluid resuscitation. Development of ACS in burn patients is associated with high mortality. Prevention, early detection and proper management may avoid this usually fatal complication. Fluid resuscitation volume is directly responsible for the development of ACS in severe burned patients. Thus, optimal fluid resuscitation can be the best prevention of IAH and ACS.

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