The effects of nursing activities on the intra-abdominal pressure of patients at risk for intra-abdominal hypertension

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.

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Identifying patients at risk for high-grade intra-abdominal hypertension following trauma laparotomy

Injury ◽

10.1016/j.injury.2014.12.020 ◽

2015 ◽

Vol 46 (5) ◽

pp. 843-848 ◽

Cited By ~ 7

Author(s):

Steven G. Strang ◽

Diederik L. Van Imhoff ◽

Esther M.M. Van Lieshout ◽

Scott K. D’Amours ◽

Oscar J.F. Van Waes

Keyword(s):

At Risk ◽

High Grade ◽

Abdominal Hypertension ◽

Patients At Risk

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Anaesthesia for urological surgery and for robotic surgery in urology and gynaecology

10.1093/med/9780199642045.003.0062 ◽

2017 ◽

Author(s):

Suzanne Odeberg-Wernerman ◽

Margareta Mure

Keyword(s):

At Risk ◽

Open Surgery ◽

Enhanced Recovery ◽

Vital Signs ◽

Early Mobilization ◽

Anaesthetic Management ◽

Abdominal Pressure ◽

Robot Assisted ◽

Carbon Dioxide Pneumoperitoneum ◽

Patients At Risk

Laparoscopic and robot-assisted laparoscopic surgical procedures are commonly used in both urology and gynaecology. These minimally invasive techniques result in early mobilization and short hospital stay and robot-assisted operations are increasingly favoured by patients and surgeons. A complex physiological response is created by the combined effects of carbon dioxide pneumoperitoneum, elevated intra-abdominal pressure, and sometimes a profound Trendelenburg position. Healthy patients tolerate this situation well, but compromised patients are at risk of developing heart failure, ischaemia, or both. Correct interpretation of vital signs can be challenging in this situation. This chapter gives an overview of the physiology during laparoscopic and robot-assisted laparoscopic surgery and gives recommendations for anaesthesia and monitoring. The field of urology and gynaecology also includes major open surgery as well as transurethral surgery and techniques for the management of urinary tract stones. The anaesthetic management and perioperative care of major open surgery, including the increasingly adopted ‘enhanced recovery after surgery’ concept, are also covered. The syndrome of transurethral resection of the prostate can still place patients at risk despite increased knowledge and improved selection of irrigation fluid.

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Intra abdominal pressure changes in meshplasty and abdominal wall plication techniques in abdominoplasty: a comparative study

International Surgery Journal ◽

10.18203/2349-2902.isj20214373 ◽

2021 ◽

Vol 8 (11) ◽

pp. 3370

Author(s):

Ramya Thulaseedharan Pillai ◽

Varghese Joseph ◽

Krishnakumar Marar

Keyword(s):

Comparative Study ◽

Abdominal Wall ◽

Symptomatic Treatment ◽

Study Groups ◽

Abdominal Pressure ◽

Rectus Diastasis ◽

Abdominal Hypertension ◽

Soft Tissue Laxity ◽

Patients At Risk ◽

Pressure Changes

Background: Measurement of intra abdominal pressures is used to identify patients at risk of intra-abdominal hypertension and abdominal compartment syndrome after abdominoplasty that may lead to tight closure of the abdomen. This comparative study was aimed at measuring the IAP of patients in groups of meshplasty and abdominal wall plication, intraoperatively and post operatively.Methods: A comparative study was conducted among 34 patients who underwent meshplasty and abdominal wall plication. Each group comprised of 17 patients. All preoperative blood investigations and pre anesthetic evaluations were done. The technique used is decided based on the soft tissue laxity, rectus diastasis and presence of ventral hernias. Intra operatively, IAP was measured soon after the placement of mesh or after Rectus plication and post operatively, IAP was measured within 24 hours. IAP was measured using the intra vesical technique using Foley’s Catheter.Results: Fifty percent of the total patients were in the age group 41-50yrs and 88.2% of the patients were females. No significant variations in IAP, either intraoperative (p=0.051) or post operative (p=0.202), was evidenced in both groups. Post operatively, patient developed minimal complications such as seroma collection, wound infection and respiratory complications, improving on symptomatic treatment and antibiotics.Conclusions: No significant intraoperative or postoperative IAP was found between the two study groups underwent meshplasty and abdominal wall placation techniques.

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