scholarly journals INTRAABDOMINAL HYPERTENSION SYNDROME: CURRENT STATE OF THE PROBLEM

2020 ◽  
pp. 35-42
Author(s):  
V. A. Samartsev ◽  
V. A. Gavrilov ◽  
B. S. Pushkarev
Keyword(s):  
Abdominal Cavity ◽  
Abdominal Pressure ◽  
Current Trends ◽  
Current State ◽  
Abdominal Hypertension ◽  
Practical Research ◽  
Intraabdominal Hypertension ◽  
Therapeutic Measures ◽  
Methods Of Treatment ◽  
Extensive Surgery

Syndrome of intra-abdominal hypertension (SIAH) is a dangerous complication that can occur in patients with a surgical profile after surgery in the abdominal cavity. Only in the past 25 years has the SIAH been recognized. According to W. Ertel et al., In one third of patients with peritonitis, pancreatic necrosis, injuries of the abdominal cavity and after extensive surgery, there is an increase in intra-abdominal pressure (IAP), while SIAH develops in 5.5% of such patients. Mortality in SIAH is 42–68%. The reason for the development of so many deaths is the presence of diagnostic, preventive and therapeutic measures, as well as differences in the interpretation of terms. Today, much attention is paid to the study of SIAH, official attempts are being made to standardize and define terms and recommended methods of treatment, but this problem needs further study. The review presents data on the current state of the problem, current trends in the diagnosis, prevention and treatment of patients with IAP and SIAH, their use in practical research.

scholarly journals Results Of Treatment Of Acute Diffuse Purulent Peritonitis Using Laparostomy

2020 ◽  
Vol 02 (11) ◽  
pp. 66-71
Author(s):  
S. A. Ruziboev ◽  
◽  
A. A. Avazov ◽  
Sh. Kh. Sattarov ◽  
A. N. Elmuradov ◽  
...  
Keyword(s):  
Bacterial Translocation ◽  
Abdominal Cavity ◽  
Multiple Organ ◽  
The Body ◽  
Abdominal Pressure ◽  
Results Of Treatment ◽  
Abdominal Hypertension ◽  
Purulent Peritonitis ◽  
Intractable Problems ◽  
Cause Of Deaths

Currently, despite significant achievements in the field of surgery, anesthesiology and resuscitation, the results of treatment of patients with advanced purulent peritonitis remain one of the most intractable problems, almost every sixth patient with acute surgical diseases and injuries of the abdominal cavity is admitted to medical institutions with peritonitis [1,3] Common peritonitis in 17-29% complicates the course of most acute surgical diseases and is the main cause of deaths in surgical hospitals [3,7]. Lethality in advanced peritonitis remains extremely high and reaches 20-39% [1,2,4,5]. In recent decades, great importance has been attached to recording intra-abdominal pressure in purulent pathology of the abdominal cavity. It was found that intra-abdominal hypertension occurs in every third patient with acute surgical pathology and negatively affects the functioning of all organs and systems of the body [1,6,8]. Pathological changes that occur with acute and excessive increase in intra-abdominal pressure (IAP) are manifestations of abdominal compartment syndrome (ACS) with disorders of the cardiovascular system; urinary disorders, disorders of perfusion of internal organs and the development of intestinal ischemia, which contributes to bacterial translocation and endogenous infection [2,7,8]. Ischemic blood flow disorders of the splanchnic zone are fraught with the development of bacterial translocation and the development of systemic inflammatory response syndrome and multiple organ failure (PON). Unsatisfactoriness with such results gave rise to a fundamentally different approach to the surgical treatment of common forms of peritonitis-the introduction of an open abdominal management method based on the ideas of I. Mikulich (1881), Jean-Louis Faure (1928), N. S. Makoch (1984) and D. Steinberg (1979).

scholarly journals The Role of Presepsin in Patients with Acute Surgical Diseases

2019 ◽  
Vol 7 (8) ◽  
pp. 1282-1286
Author(s):  
Miras Mugazov ◽  
Yermek Turgunov ◽  
Dinar Kaliyeva ◽  
Dmitriy Matyushko ◽  
Zhandos Koishibayev ◽  
...  
Keyword(s):  
Pelvic Ring ◽  
Bacterial Flora ◽  
Abdominal Cavity ◽  
Bladder Tumour ◽  
Abdominal Pressure ◽  
Normative Documents ◽  
Abdominal Hypertension ◽  
Prothrombin Index ◽  
The Republic ◽  
Critical Patients

AIM: The purpose of this study was to determine the level of significance of markers in the development of intra-abdominal hypertension in patients with acute surgical diseases of the abdominal cavity. METHODS: The authors surveyed 100 patients who were monitored at the Regional Clinical Hospital, Karaganda. The criterion for inclusion in the study was the informed consent of patients to participate in the study, the presence of acute surgical pathology, and the monitoring of intra-abdominal pressure over time. The exclusion criteria for patients from the study is the presence of sub and decompensation of associated diseases: trauma (hematoma of the bladder), bladder tumour and impaired integrity of the pelvic ring. The design of the study was by the legislation of the Republic of Kazakhstan, international ethical norms and normative documents of research organizations, approved by the ethics committee of the Karaganda State Medical University. RESULTS: According to the world scientific literature, there are 4 indicators that change their value in response to increases in pressure in the abdominal cavity: fibrinogen and prothrombin index (the main indicators of the coagulogram); marker of blood clots D-dimer; early marker of translocation of bacterial flora into the bloodstream sCD14 (presepsin). CONCLUSION: The authors concluded that the obtained data indicate that an increase in intra-abdominal pressure in acute surgical diseases of the abdominal cavity causes hypercoagulation and an increase in presepsin. Monitoring IAP with simultaneous measurement of the level of presepsin significantly improves the stratification of critical patients in need of emergency surgery.

scholarly journals Effect of intra-abdominal hypertension on the strength of the postoperative scar of a laparotomic wound

2020 ◽  
Vol 24 (2) ◽  
pp. 223-226
Author(s):  
I. K. Morar
Keyword(s):  
Mechanical Strength ◽  
Negative Impact ◽  
Abdominal Cavity ◽  
Study Groups ◽  
Laboratory Animals ◽  
Abdominal Pressure ◽  
Abdominal Hypertension ◽  
Laparotomy Wound ◽  
The Impact ◽  
Postoperative Scar

Annotation. One of the main factors of postoperative eventration is intra-abdominal hypertension, which occurs in various surgical pathologies of the abdominal cavity. Despite the presence of a large number of scientific papers on the negative effect of intra-abdominal hypertension on the morphological state of granulation tissue in the area of the laparotomy wound, there are no publications on the impact on the strength of the postoperative scar. Therefore, the study aimed to investigate in an experiment on small laboratory animals the effect of intra-abdominal hypertension on the mechanical strength of the postoperative scar of a laparotomy wound. The experiment was performed on 120 laboratory rats, which underwent a median laparotomy and brought together the edges of the musculoaponeurotic layer of the anterior abdominal wall with simple nodal sutures. The main group consisted of 72 animals who developed intra-abdominal hypertension by inserting a container (condom) with a certain amount of Furacilin into the abdominal cavity. The comparison group consisted of 48 animals who had an empty condom inserted into the abdominal cavity after laparotomy. The mechanical strength of the postoperative scar of the laparotomy wound was determined by the method of G. V. Petrovich (2010) on the 1st, 3rd, and 5th day after the creation of intra-abdominal hypertension, by measuring the level of intra-abdominal pressure at the time of rupture of the postoperative scar of the laparotomy wound. Statistical analysis of the results was performed using Microsoft Excel spreadsheets and a package of statistical processing software PAST. Differences between study groups were determined using Mann-Whitney criteria. The results of the study indicate that the created intra-abdominal hypertension leads to a decrease in the mechanical strength of the postoperative scar of the laparotomy wound. The degree of the negative impact of intra-abdominal hypertension on the strength of the postoperative scar is inversely proportional to the level of intra-abdominal pressure.

scholarly journals The Relationship Between Intraabdominal Hypertension and Preeclampsia

2016 ◽  
pp. 5
Author(s):  
Mesut A. Ünsal ◽  
Ülkü İnce ◽  
Sevil Cengiz ◽  
S. Caner Karahan ◽  
Turhan Aran
Keyword(s):  
Statistical Significance ◽  
Intraabdominal Pressure ◽  
Control Group ◽  
Abdominal Pressure ◽  
Study Group ◽  
Abdominal Hypertension ◽  
Intraabdominal Hypertension ◽  
The Mean ◽  
And Control ◽  
The Relationship

<p><strong>OBJECTIVE:</strong> We aimed to measure abdominal pressure and placental levels of malondialdehyde in patients with preeclampsia and investigate the relationship between intraabdominal pressure and clinical features of preeclampsia.<br /><strong>STUDY DESIGN:</strong> Study was conducted at a tertiary referral clinic. Study group consisted of patients with preeclampsia and control group consisted of normotensive pregnant women. Both placental malondialdehyde and intraabdominal pressure levels were studied in all patients. Intraabdominal pressure was assessed indirectly via a Foley bladder catheter both antepartum and postpartum period. Statistical comparisons among groups were made using the Mann-Whitney U test, independent T test and Chi-square test. Statistical significance was set as p&lt;0.05.<br /><strong>RESULTS:</strong> Study and control group consisted of 35 pregnant patients. The mean patients’ age, gravidity, parity, weight and BMI were not different between study and control groups. In the study group, Caesarean, preterm delivery and abdominal hypertension rate were significantly higher whereas the mean neonatal birth weight was lower. The mean antepartum and postpartum intraabdominal pressure levels were significantly higher in study group. The mean intraabdominal pressure was highest in patients with oliguria (19.8±1.8 cmH2O). Abdominal hypertension was detected in 30 (86%) patients in study group and in 3 (9%) patients in control group. The mean placental malondialdehyde level was significantly higher in patients with intraabdominal hypertension.<br /><strong>CONCLUSION:</strong> Abdominal hypertension rate is very high in patients with preeclampsia. Abdominal hypertension may have an additional role in preeclampsia.</p>

scholarly journals Case report of a giant inguinal hernia causing intestinal obstruction

2021 ◽  
Vol 8 (8) ◽  
pp. 2463
Author(s):  
R. Sanjay ◽  
Farukh Khan ◽  
Shalu Gupta ◽  
Prashant . ◽  
Akash .
Keyword(s):  
Inguinal Hernia ◽  
Abdominal Cavity ◽  
Standing Position ◽  
Abdominal Pressure ◽  
Hernia Sac ◽  
Modern Times ◽  
The Past ◽  
Abdominal Hypertension ◽  
History Of ◽  
Abdominal Compartment

Inguinal hernia is one of the ancient diseases that haunted the humanity from its very beginning to the modern times. Giant inguinal hernia is defined as an inguinal hernia that extends below the midpoint of inner thigh when the patient is in standing position. A 43 years old healthy male was affected by long standing, progressively enlarging right sided inguinal hernia for the past 21 years. His symptoms of abdominal discomfort and pain in lower abdomen after meal had worsened over time and he had lost 13 kg of weight in past 2 years. He had difficulty in micturition and gave history of constipation. Giant inguinal hernia is a type of hernia with massive contents inside the hernia sac and limited domain of abdominal cavity. The surgeon’s decision regarding the prevention of intra-abdominal hypertension is a crucial stage of overall management. Giant inguinal hernia is a very rare. It is defined as hernia sac extending below mid inner thigh in the standing position. Surgical repair is very challenging and has significant morbidity and mortality due to increased intra-abdominal pressure and abdominal compartment syndrome.

scholarly journals Prediction of kidney damage in the syndrome of intra-abdominal hypertension

2018 ◽  
Vol 22 (4) ◽  
pp. 669-673
Author(s):  
A.I. Suchodolia ◽  
K.Yu. Krenov ◽  
I.V. Loboda ◽  
V.M. Monastyrskiy
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Perfusion Pressure ◽  
Blood Pressure Measurement ◽  
Abdominal Cavity ◽  
Multiple Organ ◽  
Intraabdominal Pressure ◽  
Abdominal Pressure ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

The syndrome of intra-abdominal hypertension and abdominal compartment syndrome can complicate the course of many surgical abdominal diseases and lead to the development and progression of multiple organ failure. In particular, impaired renal blood flow is an early and significant pathogenetic link of thanatogenesis in such patients. Mortality at an abdominal compartment syndrome reaches very significant figures — 42–68% and without treatment approaches 100%. The purpose of the work is to predict renal failure in patients with intra-abdominal hypertension syndrome and abdominal compartment syndrome. A survey of 40 patients with acute surgical abdominal pathology and signs of intra-abdominal hypertension was performed. Blood pressure measurement was performed according to the recommendations of the conciliation commission on the problem of intra-abdominal hypertension syndrome (SIGA) from 2004. Also, the calculation of perfusion pressure of the abdominal cavity was performed, which is the difference between mean arterial pressure and intraabdominal pressure. The level of perfusion pressure is less than 60 mm Hg. Art. correlates with survival of patients. Determination of cystatin C was performed in the first 48 hours after hospitalization of patients in VAIT. The calculation of the results was carried out according to the standard t-criterion calculation formulas in the Exel tables. It was found that of 40 patients died — 13, and survived — 27. The reliable difference between the indicators of intra-abdominal pressure in surviving and deceased patients was acquired only at the end of the third day of observation, whereas the abdominal perfusion pressure indices significantly differed already in the first day. In the analysis of cytatine C in surviving patients, the biomarker values were 1,299±0.827, whereas in those who died 1,882±0.828, the statistical deviation was significant at p≤0.05. Thus: the cytosine C score, in combination with the dynamics of abdominal perfusion tick, can be considered as a marker that may predict the development of renal insufficiency in patients with SIGA-AKS.

scholarly journals Influence of intraabdominal hypertension on morphological changes of internal organs in experiment

2019 ◽  
Vol 23 (1) ◽  
pp. 6-11
Author(s):  
A.I. Sukhodolya ◽  
K.Yu. Krenov ◽  
I.V. Loboda ◽  
V.M. Monastyrsky
Keyword(s):  
Morphological Changes ◽  
Abdominal Cavity ◽  
Intraabdominal Pressure ◽  
Control Group ◽  
Internal Organs ◽  
Experimental Animals ◽  
Abdominal Hypertension ◽  
Wide Range ◽  
Intraabdominal Hypertension ◽  
Neutral Formalin

The development of intra-abdominal hypertension is possible with a wide range of surgical pathologies, in particular, the abdominal cavity, as well as in other nosologies and significantly aggravates the prognosis. Thus, polytrauma and major burns present up to 60% of the risk of abdominal compartment syndrome (AKS), and intestinal obstruction, peritonitis and acute destructive pancreatitis - in almost 80% of cases. The purpose of the work was to investigate the morphological changes that occur in the internal organs in an intraabdominal hypertension syndrome caused by peritonitis. The experiment was conducted on 28 guinea pigs, divided into three groups: I — the control group (n=8), the II group, in which the peritonitis was simulated by destruction of the colon in the experimental animals (n=10), III — the group of experimental animals, in which the peritonitis model was combined with a paranephrine blockade in combination with a blockage of the circular ligament of the liver (n=10). In all experimental animals, intraabdominal pressure was measured every 6 hours during the day. The results were processed using Microsoft Excel spreadsheet formulas using the Student t criterion. For morphological study section material was used (fragments of the kidneys, small intestine and peritoneum). To facilitate cutting the pieces, we carried out preliminary fixation of organs in 10% neutral formalin (at least 24 hours). From each organ, cut into 1–2 bits or ribbons, which were fixed in 10% neutral formalin solution. After posting according to the generally accepted method, bits were poured into paraffin. Paraffin sections 5–7 microns thick were stained with hematoxylin and eosin. As a result of experimental work, it has been found that combined regional blockades effectively reduce intra-abdominal pressure within six hours after use, but their effect is short-lived. In the experimental peritonitis group, with the implementation of regional blockades with lidocaine solution, the morphological changes of the kidneys and peritoneum were less pronounced. Improvement of the technique of regional blockades, in particular the continued infusion of local anesthetics, can significantly increase the effectiveness of the technique without side effects that are inherent in, in particular, peridural analgesia.

scholarly journals The Choice of Treatment Tactics in Patients with Severe Acute Pancreatitis Taking Into Account the Factor of Intra-Abdominal Hypertension

2020 ◽  
Vol 9 (3) ◽  
pp. 400-409
Author(s):  
B. M. Belik ◽  
G. M. Chirkinyan ◽  
R. S. Tenchurin ◽  
Z. A. Abduragimov ◽  
D. V. Mareyev ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Treatment Strategy ◽  
Apache Ii ◽  
Abdominal Pressure ◽  
Group I ◽  
Abdominal Hypertension ◽  
Choice Of Treatment ◽  
Therapeutic Measures ◽  
Severity Of The Disease

Relevance. Increased intra-abdominal pressure (IAP) in patients with severe acute pancreatitis (AP) is one of the triggers for the development of a functional organ failure, which leads to death. In this case, the favorable outcome of treatment of patients with severe AP is largely determined by early diagnosis and timely elimination of intra-abdominal hypertension (IAH). At the same time, there is no unified and agreed opinion on the principles and specific methods of eliminating the IAH syndrome in patients with severe AP today, which greatly complicates the choice of treatment strategy and tactics.Aim of study. To assess the role and clinical significance of IAP monitoring in patients with severe AP with various manifestations of organ dysfunction and, offer a set of therapeutic measures aimed at resolving intra-abdominal hypertension.Material and methods. The current study included 199 patients with severe AP, divided into two groups depending on the chosen treatment strategy. Group I included 107 patients where the diagnosis and treatment of the disease corresponded to generally accepted standards. Group II included 92 patients, where, in order to objectify the severity and prognosis of the course of AP, along with standard studies, IAP and APACHE II scale indicators were additionally monitored during treatment, and the severity of organ dysfunctions was assessed. In these patients the choice of medical tactics, including the use of conservative and surgical interventions, was made on a differentiated basis, based on the severity of the disease and the dynamics of the IAH.Results. The role and significance of IAP monitoring and APACHE II scale indicators in the treatment of patients with severe AP were determined. The use of a differentiated approach to the choice of treatment strategies for patients with AP considering the severity of the disease and severity of IAH syndrome results in reduced hospital mortality by 10.3% and reduced postoperative mortality by 11.4%.Conclusion. Monitoring of intra-abdominal pressure and APACHE II scale indices in conjunction with standard clinical and laboratory parameters allows patients to be clearly stratified according to the severity of acute pancreatitis, which helps optimize the choice of treatment tactics, including methods and timing of surgery, as well as the use of a set of effective therapeutic measures aimed at eliminating intra-abdominal hypertension.

scholarly journals Neutrophil Gelatinase-Associated Lipocalin as a Marker for Renal Dysfunction Detection in Critically Ill Patients with Increased Intraabdominal Pressure

2017 ◽  
Vol 3 (1) ◽  
pp. 24-28
Author(s):  
Claudiu Puiac ◽  
Janos Szederjesi ◽  
Alexandra Lazăr ◽  
Codruța Bad ◽  
Lucian Pușcașiu
Keyword(s):  
Renal Function ◽  
Intensive Care ◽  
Creatinine Clearance ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Abdominal Cavity ◽  
Intraabdominal Pressure ◽  
Abdominal Pressure ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

Abstract Introduction: Elevated intraabdominal pressure (IAP) it is known to have an impact on renal function trough the pressure transmitted from the abdominal cavity to the vasculature responsible for the renal blood flow. Intraabdominal pressure is found to be frequent in intensive care patients and also to be a predictor of mortality. Intra-abdominal high pressure is an entity that can have serious impact on intensive care admitted patients, studies concluding that if this condition progresses to abdominal compartment syndrome mortality is as high as 80%. Aim: The aim of this study was to observe if a link between increased intraabdominal pressure and modification in renal function exists (NGAL, creatinine clearance). Material and Method: The study enrolled 30 critically ill patients admitted in the Intensive Care Unit of SCJU Tîrgu Mures between November 2015 and August 2016. The study enrolled adult, hemodynamically stable patients admitted in intensive critical care - defined by a normal blood pressure maintained without any vasopressor or inotropic support, invasive monitoring using PICCO device and abdominal pressure monitoring. Results: The patients were divided into two groups based on the intraabdominal pressure values: normal intraabdominal pressure group= 52 values and increased intraabdominal group= 35 values. We compared the groups in the light of NGAL values, 24 hours diuresis, GFR and creatinine clearance. The groups are significantly different when compared in the light of NGAL values and GFR values. We obtained a statistically significant correlation between NGAL value and 24 hour diuresis. No other significant correlations were encountered between the studied items. Conclusions: NGAL values are increased in patients with high intraabdominal pressure which may suggest its utility as a cut off marker for patients with increased intraabdominal pressure. There is a significant decreased GFR in patient with elevated intraabdominal pressure, observation which can help in early detection of renal injury in patients due to high intraabdominal pressure. No correlation was found between creatinine clearance and increased intraabdominal pressure.

An overview of the current state of interlibrary loans in South Africa

2015 ◽  
Vol 43 (2) ◽  
pp. 76-83
Author(s):  
Jenny Raubenheimer ◽  
John Stephen van Niekerk
Keyword(s):  
South Africa ◽  
South African ◽  
Information Provision ◽  
Literature Study ◽  
Content Type ◽  
Current Trends ◽  
Current State ◽  
Computer Library ◽  
Practical Implications ◽  
Essential Service

Purpose – The purpose of this paper is to review interlending development in South Africa and current trends in interlending. Design/methodology/approach – Literature study and survey. Findings – Interlending is still an essential service in South Africa. Interlending systems must be used effectively to ensure rapid delivery of requested interlibrary loans. There is a significant use of WorldShare ILL, but there is a scope for substantial development. Research limitations/implications – This is not a comprehensive study but focusses on current interlending activities at some of the larger South African academic and special libraries and the use of Online Computer Library Centre systems. Practical implications – The paper provides some historical information and the extent of current interlending and systems used. Social implications – The paper gives an indication of the value of interlending in South Africa and its contribution to information provision. Originality/value – The paper provides a snapshot of interlending in South Africa and areas for development.

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