What’s new in medical management strategies for raised intra-abdominal pressure: evacuating intra-abdominal contents, improving abdominal wall compliance, pharmacotherapy, and continuous negative extra-abdominal pressure

Intra-abdominal hypertension occurs in 50% of all patients admitted to the intensive care unit and is associated with significant morbidity and mortality. Intra-abdominal hypertension is defined as a sustained, pathologic rise in intra-abdominal pressure to 12 mm Hg or more. Patients with intra-abdominal hypertension may progress to abdominal compartment syndrome. Early identification and treatment of this condition will improve patient outcome. Patients at risk for intra-abdominal hypertension include those with major traumatic injury, major surgery, sepsis, burns, pancreatitis, ileus, and massive fluid resuscitation. Predisposing factors include decreased abdominal wall compliance, increased intraluminal contents, increased peritoneal cavity contents, and capillary leak/fluid resuscitation.

Download Full-text

Modifications of Diaphragmatic Activity Induced by Midline Laparotomy and Changes in Abdominal Wall Compliance

Archivos de Bronconeumología (English Edition) ◽

10.1016/s1579-2129(09)71785-9 ◽

2009 ◽

Vol 45 (1) ◽

pp. 30-35

Author(s):

Joaquim Gea ◽

Juan Bautista Gáldiz ◽

Norman Comtois ◽

Ercheng Zhu ◽

Igor Salazkin ◽

...

Keyword(s):

Abdominal Wall ◽

Midline Laparotomy ◽

Wall Compliance ◽

Abdominal Wall Compliance

Download Full-text

35: MESH HERNIORRHAPHY REVERSES INTERNAL OBLIQUE MUSCLE ATROPHY AND PARTIALLY RESTORES ABDOMINAL WALL COMPLIANCE

Plastic & Reconstructive Surgery ◽

10.1097/01.prs.0000396722.02649.eb ◽

2011 ◽

Vol 127 ◽

pp. 26

Author(s):

EJ Culbertson ◽

L Xing ◽

Y Wen ◽

MG Franz

Keyword(s):

Abdominal Wall ◽

Muscle Atrophy ◽

Oblique Muscle ◽

Internal Oblique Muscle ◽

Wall Compliance ◽

Internal Oblique ◽

Abdominal Wall Compliance

Download Full-text

Incisional Hernia Defect Size and Abdominal Wall Compliance

Plastic & Reconstructive Surgery ◽

10.1097/01.prs.0000455418.80357.d4 ◽

2014 ◽

Vol 134 ◽

pp. 72-73

Author(s):

Brett Trzcinski ◽

Angela Myers ◽

William M. Kuzon

Keyword(s):

Incisional Hernia ◽

Abdominal Wall ◽

Defect Size ◽

Hernia Defect ◽

Wall Compliance ◽

Abdominal Wall Compliance

Download Full-text

Abdominal Decompression in Children

Critical Care Research and Practice ◽

10.1155/2012/180797 ◽

2012 ◽

Vol 2012 ◽

pp. 1-11

Author(s):

J. Chiaka Ejike ◽

Mudit Mathur

Keyword(s):

Medical Management ◽

Patient Survival ◽

Management Strategies ◽

Critically Ill Children ◽

Abdominal Pressure ◽

Risk Of Mortality ◽

Abdominal Hypertension ◽

Abdominal Decompression ◽

Positive Effect ◽

Abdominal Compartment

Abdominal compartment syndrome (ACS) increases the risk for mortality in critically ill children. It occurs in association with a wide variety of medical and surgical diagnoses. Management of ACS involves recognizing the development of intra-abdominal hypertension (IAH) by intra-abdominal pressure (IAP) monitoring, treating the underlying cause, and preventing progression to ACS by lowering IAP. When ACS is already present, supporting dysfunctional organs and decreasing IAP to prevent new organ involvement become an additional focus of therapy. Medical management strategies to achieve these goals should be employed but when medical management fails, timely abdominal decompression is essential to reduce the risk of mortality. A literature review was performed to understand the role and outcomes of abdominal decompression among children with ACS. Abdominal decompression appears to have a positive effect on patient survival. However, prospective randomized studies are needed to fully understand the indications and impact of these therapies on survival in children.

Download Full-text