abdominal hypertension
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2021 ◽  
Vol 50 (1) ◽  
pp. 165-165
Author(s):  
Ashish Khanna ◽  
Steven Minear ◽  
Amit Prabhakar ◽  
Andrea Kurz ◽  
Kelly Stanton ◽  
...  

2021 ◽  
Vol 12 (3) ◽  
pp. 38-46
Author(s):  
N. S. Morozova ◽  
A. A. Mamedov ◽  
D. Y. Lakomova ◽  
L. D. Maltseva ◽  
O. L. Morozova

Aim. To establish the effect of experimental intra-abdominal hypertension (IAH) on the teeth-jaw system of rats in the long-term period based on the study of pro-inflammatory cytokines and morphological analysis of the elements of the temporomandibular joint (TMJ) and salivary glands.Materials and methods. The experiment was carried out on 60 newborn rats; IAH was modelled by injecting collagen into the abdominal cavity to a predetermined level of intra-abdominal pressure. The rats were evenly (n = 20) divided into 3 groups: 1st - control; 2nd and 3rd - with light and severe IAH, respectively. Serum levels of IL-18, MCP-1, NGAL were determined by multiplex analysis after 10 and 120 days, VEGF-C - after 10 days - by ELISA. The morphological examination of the TMJ and salivary glands was performed using a Leica DM2000 microscope after 120 days.Results. After 10 days and 120 days, blood serum levels of NGAL, IL-18 and MCP-1 were statistically significantly increased in groups 2 and 3 compared to the control; the concentration of MCP-1 increased in proportion to the severity of the IAH with the maximum values in group 3. After 10 days, the level of VEGF was significantly increased in group 2 compared to the control group (p < 0.02). Inflammation of the TMJ was observed significantly more often in groups 2 and 3 than in the control group (p = 0.0002). In group 3, circulatory disorders and bone marrow degeneration of the TMJ, as well as inflammation, circulatory disorders and hyperplasia of the lymphoid tissue of the salivary glands were statistically significantly more often compared to groups 1 and 2.Conclusion. In the long term, experimental IAH showed an increase in the levels of markers of inflammation and hypoxia in the blood serum of rats; the severity of synovitis and sialadenitis grew with an increase in the level of intra-abdominal pressure; the maximum deviations in inflammation markers and morphological changes in the TMJ and salivary glands of rats were observed in the group with severe IAH.


Author(s):  
Hashem Bark Awadh Abood ◽  
Sadeel Fahad Daghistani ◽  
Nouf Hashem Koshak ◽  
Yazid Ali Alghamdi ◽  
Sahad sami Ghamri ◽  
...  

Open abdomen (OA) is becoming more common, primarily to prevent intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) following emergency abdominal surgery. The purpose of temporary abdominal closure (TAC) techniques is no longer just abdomen coverage; fluid regulation and early fascial closure are now important considerations. TAC techniques for leaving the abdomen open are numerous. The ideal one should be simple to apply and remove, allow for quick access to a surgical second opinion, drain secretions, ease primary closure with acceptable morbidity and mortality, allow for easy nursing, and, finally, be readily available and inexpensive. Over the years, several TAC methods have been proposed. In this review, we overview different techniques for temporary abdominal closure and its advantages and disadvantages.


2021 ◽  
Vol 12 ◽  
Author(s):  
Marijan Tepes ◽  
Slaven Gojkovic ◽  
Ivan Krezic ◽  
Helena Zizek ◽  
Hrvoje Vranes ◽  
...  

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.


2021 ◽  
Vol 12 ◽  
Author(s):  
Zeyu Zhao ◽  
Zhengchang Guo ◽  
Zhengliang Yin ◽  
Yue Qiu ◽  
Bo Zhou

Background: Intestinal damage caused by intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) can lead to the ectopic gut microbiota, which can contribute to liver injury via portal veins. Therefore, it is speculated that gut microbiota disorder caused by IAH/ACS may result in liver injury. The relationship between gut microbiota and IAH/ACS-related liver injury was investigated in this study.Methods: A model of IAH was established in rats, and 16S rRNA sequencing was analyzed for gut microbiota in the feces of rats. The elimination of gut microbiota was completed by antibiotics gavage, and fecal microbiota transplantation (FMT) was used to change the composition of gut microbiota in rats.Results: In addition to the traditional cause of liver blood vessel compression, liver injury caused by IAH was also associated with gut microbiota dysbiosis. Gut microbiota clearance can relieve liver injury caused by IAH, while FMT from IAH-intervened rats can aggravate IAH-related liver injury.Conclusion: The gut microbiota was one of the most important factors contributing to the IAH-related liver injury, and the JNK/p38 signaling pathway was activated in this process.


2021 ◽  
pp. 71-80
Author(s):  
M. I. Pokidko ◽  
I. M. Vovchuk ◽  
A. A. Zhmur ◽  
T. V. Formanchuk ◽  
M. A. Gudz ◽  
...  

The aim of the work is to analyze and summarize current data on the problem of reperfusion injury and intra-abdominal hypertension syndrome in patients with acute pancreatitis: the causes of their occurrence, approaches to their prevention and treatment. Results. The analysis is based on sources that were searched in scientometric databases Google Scholar, MedLine, Web of Science, Scopus for 2013-2019. Disorders of microcirculation are one of the factors influencing the development of acute pancreatitis, namely, stimulate the increase of pancreatic enzymes level, interstitial edema and infiltration by inflammatory response cells. On the other hand, ischemia can complicate the course of the disease with the development of ischemia-reperfusion syndrome and intra-abdominal hypertension. The analyzed data concerning the prevention and treatment of these syndromes in acute pancreatitis are contradictory, which does not allow to form a unified approach to the treatment of the above conditions. Conclusions. In order to reduce mortality in acute pancreatitis, it is important to study possible ways to prevent and further manage patients with acute pancreatitis, accompanied by reperfusion injury and intra-abdominal hypertension.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qian-Mei Zhu ◽  
Hong Tu ◽  
Bing Hu ◽  
Xiao Wang

Abstract Background Endoscopic submucosal dissection (ESD) has been recognized as a safe and minimally invasive technique for the removal of early gastric cancer. Here, we describe a case of extended-duration ESD for a gastric tumor associated with intraoperative perforation and bleeding. Unfortunately, the patient developed acute lung injury (ALI) after the operation. Case presentation: A 72-year-old woman received ESD for a gastric tumor under general anesthesia. Preoperatively, endoscopic ultrasonography (EUS) showed a 3.1 × 3.5 cm hypoechoic, well-defined mass at the junction of the antrum and body of the stomach on the greater curvature, originating in the muscularis propria layer. During the ESD procedure, when the submucosal mass was stripped, it was found to be closely adhered to the muscular layer and serosa layer, and a full-thickness incision was performed. The abdominal cavity was gradually filled with carbon dioxide gas, and abdominal puncture was performed to reduce intra-abdominal hypertension (IAH). Because the mass adhered to the greater omentum and there was more bleeding during the operation, a long duration of hemostasis and suturing of the wound was required. The whole operation lasted nearly 9 h, and total blood loss was 800 ml. After surgery, acute lung injury was suspected, and the patient was sent to the intensive care unit (ICU) for further treatment. Conclusions The operation time of ESD and IAH caused by perforation are closely related to a poor prognosis. We should pay attention to the impact of operation time on patients and improve awareness regarding protecting important organ functions.


2021 ◽  
Author(s):  
Wenhua He ◽  
Peng Chen ◽  
Yupeng Lei ◽  
Liang Xia ◽  
Pi Liu ◽  
...  

Abstract Background: Intra-abdominal hypertension (IAH) in acute pancreatitis (AP) is associated with deterioration in organ function. This trial aimed to assess the efficacy of neostigmine for IAH in patients with AP.Methods: In this single-centre, randomized trial, consenting patients with IAH within 2 weeks of AP onset received conventional treatment for 24 hours. Patients with sustained intra-abdominal pressure (IAP) ≥ 12 mmHg were randomized to receive intramuscular neostigmine (1 mg every 12 hours increased to every 8 hours or every 6 hours, depending on response) or continue conventional treatment for 7 days. The primary outcome was the change of IAP after randomization. Results: A total of 80 patients were recruited to neostigmine (n = 40) or conventional treatment (n = 40). There was no significant difference in baseline parameters. IAP levels were significantly lower in neostigmine group than conventional treatment group at 9 hour (13.8 ± 3.5 vs 15.0 ± 3.1, P = 0.038), 15 hour (13.3 ± 3.4 vs 14.7 ± 3.1, P = 0.015), and 168 hour (12.2 ± 2.7 vs 13.6 ± 3.5, P = 0.045) after randomisation. This effect was more pronounced in patients with baseline IAP ≥ 15 mmHg (all P ≤ 0.038). Stool volume was consistently higher in the neostigmine group during the 7-day period (all P < 0.05). Other secondary outcomes were not significantly different between the two groups.Conclusion: Neostigmine reduced IAP and promoted defecation in patients with AP and IAH. These results warrant a larger, placebo-controlled, double-blind phase III trial.Trial registration: Clinical Trial No: NCT02543658 (registered August /27, 2015). https://clinicaltrials.gov/ct2/show/NCT02543658


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