scholarly journals Non-Invasive Intra-Abdominal Pressure Measurement by Means of Transient Radar Method: In Vitro Validation of a Novel Radar-Based Sensor

Sensors ◽  
2021 ◽  
Vol 21 (18) ◽  
pp. 5999
Author(s):  
Salar Tayebi ◽  
Ali Pourkazemi ◽  
Manu L.N.G. Malbrain ◽  
Johan Stiens
Keyword(s):  
Abdominal Wall ◽  
Pressure Gauge ◽  
Urethral Injury ◽  
Abdominal Pressure ◽  
P Value ◽  
Radar Method ◽  
Abdominal Hypertension ◽  
Tract Infections ◽  
Abdominal Compartment

Intra-abdominal hypertension, defined as an intra-abdominal pressure (IAP) equal to or above 12 mmHg is one of the major risk-factors for increased morbidity (organ failure) and mortality in critically ill patients. Therefore, IAP monitoring is highly recommended in intensive care unit (ICU) patients to predict development of abdominal compartment syndrome and to provide a better care for patients hospitalized in the ICU. The IAP measurement through the bladder is the actual reference standard advocated by the abdominal compartment society; however, this measurement technique is cumbersome, non-continuous, and carries a potential risk for urinary tract infections and urethral injury. Using microwave reflectometry has been proposed as one of the most promising IAP measurement alternatives. In this study, a novel radar-based method known as transient radar method (TRM) has been used to monitor the IAP in an in vitro model with an advanced abdominal wall phantom. In the second part of the study, further regression analyses have been done to calibrate the TRM system and measure the absolute value of IAP. A correlation of –0.97 with a p-value of 0.0001 was found between the IAP and the reflection response of the abdominal wall phantom. Additionally, a quadratic relation with a bias of −0.06 mmHg was found between IAP obtained from the TRM technique and the IAP values recorded by a pressure gauge. This study showed a promising future for further developing the TRM technique to use it in clinical monitoring.

Continuous Intra-Gastral Monitoring of Intra-Abdominal Pressure in Critically ill Children – A Validation Study

2020 ◽  
Author(s):  
Torsten Kaussen ◽  
Miriam Gutting ◽  
Florian Lasch ◽  
Dietmar Boethig ◽  
Alexander von Gise ◽  
...  
Keyword(s):  
Water Column ◽  
Critically Ill ◽  
Tertiary Care ◽  
Critically Ill Children ◽  
Abdominal Pressure ◽  
Abdominal Hypertension ◽  
Gastric Pressure ◽  
Abdominal Compartment

Abstract Background: In critically ill children, detection of intra-abdominal hypertension (IAH, >10mmHg) and abdominal compartment syndrome (ACS, =IAH + organ dysfunction) is paramount and usually monitored through intra-vesical pressures (IVP) as current standard. IVP however carries important disadvantages, being time-consuming, discontinuous, with infection risk through observer-dependent manipulation, and ill-defined for catheter sizes. Therefore, we sought to validate air-capsule-based measurement of intra-gastric pressure (ACM-IGP).Methods: We prospectively compared ACM-IGP with IVP both in-vivo and in-vitro (water-column), according to Abdominal-Compartment-Society validation criteria. We controlled for patient age, admission diagnosis, gastric filling/propulsive medication, respiratory status, sedation levels and transurethral catheters, all influencing intra-abdominal pressure (IAP).Results: In tertiary care PICU setting, finally, n=97 children were enrolled (median age, 1.3 years [range, 0 days -17 years], LOS-PICU 8.0 [1-332] days, PRISM-III-Score 13 [0-35]). In n=2.770 measurements pairs, median IAP was 6.7 [0.9 -23.0] mmHg. n=38 (39%) children suffered from IAH>10mmHg, n=4 from ACS. In-vitro against water-column, ACM-IGP correlated perfectly (r² 0.99, mean bias -0.1±0.5 mmHg, limits-of-agreement (LOA) -1.1/+0.9, percentage error [PE] 12%) as compared with IVP (r² 0.98, bias +0.7±0.6 mmHg, LOA -0.5/+1.9, PE 15%). With larger IVP catheters at higher pressure levels, IVP underestimated pressures against water-column. In-vivo, agreement between either technique was strong (r² 0.95, bias 0.3±0.8 mmHg, LOA -1.3/+1.9mmHg, PE 23%). No impact of predefined control variables on measurement agreement was observed. Conclusions: In a large PICU population with high IAH prevalence, ACM-IGP agreed favourably with IVP. More wide-spread usage of ACM-IGP may improve detection rates of ACS in critically ill children. Trial registration: WHO-ICTRP-No. DRKS00006556 (German Clinical Trial Register). Registeres 12th September 2014, URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00006556

Recurrent Abdominal Compartment Syndrome: An Inciting Factor of the Second Hit Phenomenon

2009 ◽  
Vol 75 (12) ◽  
pp. 1193-1198 ◽  
Author(s):  
Juan C. Duchesne ◽  
Catherine C. Baucom ◽  
Kelly V. Rennie ◽  
Jon Simmons ◽  
Norman E. Mcswain
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Wall ◽  
Abdominal Compartment Syndrome ◽  
Hospital Length Of Stay ◽  
Abdominal Pressure ◽  
Abdominal Wall Closure ◽  
Second Hit ◽  
Increased Risk ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

Intra-abdominal hypertension (IAH) after damage control laparotomy (DCL) is not unusual and because of this, patients are treated with open-abdomen techniques to prevent abdominal compartment syndrome (ACS). The occurrence of recurrent ACS (R-ACS) after abdominal wall closure under tension in patients managed with DCL can be a trigger factor for second hit syndrome. Outcomes in this subset have not been previously described. In this 1-year retrospective study of severely injured patients in a Level I trauma center managed with DCL and sequential abdominal wall closure, 26 patients were identified. After attempted abdominal wall closure, 13 (50%) patients had R-ACS and 13 (50%) non-R-ACS. R-ACS patients had a statistically significant higher incidence of multisystem organ failure, acute respiratory distress syndrome, and sepsis as well as requiring longer ventilator support and longer hospital length of stay. We concluded that failure to recognize and treat IAH with development of R-ACS after tension abdominal wall closure in patients with DCL will trigger the second hit syndrome with increased risk of morbidity. Institution of a management algorithm with intra-abdominal pressure/abdominal perfusion pressure surveillance at the time of abdominal wall closure can potentially ameliorate complications.

scholarly journals Intra-Abdominal Hypertension and Abdominal Compartment Syndrome after Abdominal Wall Reconstruction: Quaternary Syndromes?

2016 ◽  
Vol 106 (2) ◽  
pp. 97-106 ◽  
Author(s):  
A. W. Kirkpatrick ◽  
D. Nickerson ◽  
D. J. Roberts ◽  
M. J. Rosen ◽  
P. B. McBeth ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Organ Failure ◽  
Abdominal Wall ◽  
Abdominal Compartment Syndrome ◽  
Abdominal Wall Reconstruction ◽  
Abdominal Hernia ◽  
Abdominal Pressure ◽  
Systemic Complications ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

Background and Aims: Reconstruction with reconstitution of the container function of the abdominal compartment is increasingly being performed in patients with massive ventral hernia previously deemed inoperable. This situation places patients at great risk of severe intra-abdominal hypertension and abdominal compartment syndrome if organ failure ensues. Intra-abdominal hypertension and especially abdominal compartment syndrome may be devastating systemic complications with systematic and progressive organ failure and death. We thus reviewed the pathophysiology and reported clinical experiences with abnormalities of intra-abdominal pressure in the context of abdominal wall reconstruction. Material and Methods: Bibliographic databases (1950–2015), websites, textbooks, and the bibliographies of previously recovered articles for reports or data relating to intra-abdominal pressure, intra-abdominal hypertension, and the abdominal compartment syndrome in relation to ventral, incisional, or abdominal hernia repair or abdominal wall reconstruction. Results: Surgeons should thus consider and carefully measure intra-abdominal pressure and its resultant effects on respiratory parameters and function during abdominal wall reconstruction. The intra-abdominal pressure post-operatively will be a result of the new intra-peritoneal volume and the abdominal wall compliance. Strategies surgeons may utilize to ameliorate intra-abdominal pressure rise after abdominal wall reconstruction including temporizing paralysis of the musculature either temporarily or semi-permanently, pre-operative progressive pneumoperitoneum, permanently removing visceral contents, or surgically releasing the musculature to increase the abdominal container volume. In patients without complicating shock and inflammation, and in whom the abdominal wall anatomy has been so functionally adapted to maximize compliance, intra-abdominal hypertension may be transient and tolerable. Conclusions: Intra-abdominal hypertension/abdominal compartment syndrome in the specific setting of abdominal wall reconstruction without other complication may be considered as a quaternary situation considering the classification nomenclature of the Abdominal Compartment Society. Greater awareness of intra-abdominal pressure in abdominal wall reconstruction is required and ongoing study of these concerns is required.

scholarly journals Continuous intra-gastral monitoring of intra-abdominal pressure in critically ill children: a validation study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
T. Kaussen ◽  
M. Gutting ◽  
F. Lasch ◽  
D. Boethig ◽  
A. von Gise ◽  
...  
Keyword(s):  
Water Column ◽  
Critically Ill ◽  
Tertiary Care ◽  
Critically Ill Children ◽  
Abdominal Pressure ◽  
Abdominal Hypertension ◽  
Gastric Pressure ◽  
Abdominal Compartment

Abstract Background In critically ill children, detection of intra-abdominal hypertension (IAH > 10 mmHg) and abdominal compartment syndrome (ACS = IAH + organ dysfunction) is paramount and usually monitored through intra-vesical pressures (IVP) as current standard. IVP, however, carries important disadvantages, being time-consuming, discontinuous, with infection risk through observer-dependent manipulation, and ill-defined for catheter sizes. Therefore, we sought to validate air-capsule-based measurement of intra-gastric pressure (ACM-IGP). Methods We prospectively compared ACM-IGP with IVP both in vivo and in vitro (water column), according to Abdominal-Compartment-Society validation criteria. We controlled for patient age, admission diagnosis, gastric filling/propulsive medication, respiratory status, sedation levels and transurethral catheters, all influencing intra-abdominal pressure (IAP). Results In tertiary care PICU setting, finally, n = 97 children were enrolled (median age, 1.3 years [range 0 days–17 years], LOS-PICU 8.0 [1–332] days, PRISM-III-Score 13 [0–35]). In n = 2.770 measurements pairs, median IAP was 6.7 [0.9–23.0] mmHg, n = 38 (39%) children suffered from IAH > 10 mmHg, n = 4 from ACS. In vitro against water column, ACM-IGP correlated perfectly (r2 0.99, mean bias − 0.1 ± 0.5 mmHg, limits of agreement (LOA) − 1.1/+ 0.9, percentage error [PE] 12%) as compared with IVP (r2 0.98, bias + 0.7 ± 0.6 mmHg, LOA − 0.5/+ 1.9, PE 15%). With larger IVP catheters at higher pressure levels, IVP underestimated pressures against water column. In vivo, agreement between either technique was strong (r2 0.95, bias 0.3 ± 0.8 mmHg, LOA − 1.3/+ 1.9 mmHg, PE 23%). No impact of predefined control variables on measurement agreement was observed. Conclusions In a large PICU population with high IAH prevalence, ACM-IGP agreed favourably with IVP. More widespread usage of ACM-IGP may improve detection rates of ACS in critically ill children. Trial registration WHO-ICTRP-No. DRKS00006556 (German Clinical Trial Register). Registered 12th September 2014, URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00006556

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.

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