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intra abdominal hypertension :: Article Creator

Intra-Abdominal Hypertension

Despite increasing interest in intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) as causes of significant morbidity and mortality among the critically ill, unanswered questions cloud the understanding of the pathophysiology of these conditions: • Are IAH and ACS synonymous? • What are the ideal methods of measuring and lowering intra-abdominal pressure (IAP)? • When should we think of IAH? • Can IAH be prevented? • What level of IAP requires abdominal decompression? Written by two experts in critical care and IAP, Intra-Abdominal Hypertension is a distillation of the current literature and furthers the understanding of these complex critical conditions. Using a step-by-step approach and illustrative figures, this clinical handbook presents a concise overview of consensus definitions, measurement methods, organ assessment and treatment options. Intra-Abdominal Hypertension is essential reading for all members of the intensive care multidisciplinary team, including experienced and junior physicians, anesthetists and nurses.

  • Contains a complete and concise overview of IAH and ACS which aids quick and accurate learning
  • List of all currently available IAP measurement tools enables decisive treatment
  • Summary of consensus definitions distils the current literature and clarifies these conditions
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  • Date Published: September 2013
  • format: Paperback
  • isbn: 9780521149396
  • length: 253 pages
  • dimensions: 186 x 122 x 13 mm
  • weight: 0.29kg
  • contains: 59 b/w illus.
  • availability: Available
    • Table of Contents

    List of abbreviationsPart I. Understanding Intra-Abdominal Hypertension: What to Worry About?:1. What is intra-abdominal pressure?2. Definitions3. Principles of IAP measurement4. Systems available to measure IAP5. Pitfalls of IAP monitoringPart II. Underlying Predisposing Conditions: When to Worry?:6. Decreased abdominal compliance7. Increased abdominal content8. Capillary leak and fluid resuscitationPart III. Specific Conditions: When to Worry More?:9. Pancreatitis10. Children11. Trauma12. Burns13. Obesity14. Pregnancy and othersPart IV. Consequences of Intra-Abdominal Hypertension: Why to Worry?:15. Cardiovascular system and IAH16. Respiratory system and IAH17. Renal system and IAH18. Central nervous system and IAH19. Other organs and IAH20. How to define gastrointestinal failure?21. Polycompartment syndromesPart V. Treatment:22. Improvement of abdominal wall compliance23. Evacuation of intra-luminal contents24. Evacuations of abdominal fluid collections25. Correction of capillary leaks and fluid balance26. Specific treatments for intra-abdominal hypertension and abdominal compartment syndrome27. Surgical treatment28. Open abdomen management and temporary abdominal closurePart VI. The Future:29. The future of IAH and ACSIndex.

    Authors

    Manu MalbrainManu Malbrain, MD, PhD is Director of ICU and High Care Burn Unit, ZNA Stuivenberg, Antwerp. He is an ESICM Chris Stoutenbeek Award winner and the founding President of The World Society of the Abdominal Compartment Syndrome (WSACS).

    Jan De WaeleJan De Waele, MD, PhD is Senior Lecturer at Ghent University and an intensivist at Ghent University Hospital, Ghent. He is Chair of the Clinical Trials Working Group of the WSACS.


    116 Measuring Of Intra-Abdominal Pressure In Critically Ill Children By Nurses

    Objective of the study: Delayed diagnosis of increased intra-abdominal pressure in PICU patients increases morbidity and mortality rates. In 2007 our PICU implemented a protocol for indirect intra-abdominal pressure (IAP) measurements by an indwelling bladder catheter using a pressure transducer. One of the indications to start IAP measurement is an increased abdominal distension. The aim of this study was to evaluate the effects of this protocol, including the nurses' compliance.

    Methods: This retrospective study included patients admitted between 2007-2009. Children who underwent IAP measurements and/or abdominal girth measurements were identified from the Patient Data Management System and their records were analyzed.

    Results: Over the study period 36 children (19 male) with a mean age of 23 months (±49.3) underwent IAP measurements and 175 underwent three or more abdominal girth measurements. Both measurements were performed in 23 children. IAP measurements were mostly performed in neonates (52.8%) after closure of abdominal wall defects. The median number of IAP measurements was 14 (range 3-79); the median IAP was 8 mmHg (range 1-44). Eleven children (31%) had an IAP > 20 mmHg, indicating abdominal compartment syndrome. Most patients were treated conservatively and three underwent a surgical intervention.

    Conclusions: This study shows that after implementation of the IAP protocol nurses most often applied abdominal girth measurements in cases of suspected increased intra-abdominal pressure. We can conclude the nurses' compliance is moderate with IAP protocol. Strategies should be used to improve this.


    Abdominal Fat Linked To High Blood Pressure

    Researchers at National Yang-Ming University in Taipei, Taiwan said in a new study that "apple-shaped" adults who have the most abdominal fat in their middle age have an increased risk of developing hypertension. The researchers examined data on 2,377 Chinese adults aged 30 and above.

    Some 25 percent of the subjects developed hypertension during the course of the 10-year study. Researchers found that people who had large waistlines at the beginning of the study had a higher risk for hypertension than those who had little or no abdominal fat.

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    Even in otherwise healthy individuals, an expanding waistline meant high blood pressure. The findings of the study are published in the American Journal of Hypertension.

    Dr. Chen Huan Chen, lead author of the study told Reuters that regardless of the current status on blood pressure, abdominal fat always increased blood pressure.

    Source-MedindiaRAS





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