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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Abdominal pressure, abdominal hypertension and abdominal compartment syndrome are not synonyms but well-differentiated entities which have been studied over the last century in patients who have medical or surgical problems and in those who have undergone laparotomies to control abdominal damage. There are numerous bibliographical references and studies which have been carried out in this field by medical personnel to provide evidence of a tight relationship among abdominal hypertension and secondary physio-pathological alterations related to abdominal hypertension; therefore, it is important to monitor patients which will help to prevent abdominal compartment syndrome. The indirect intra-abdominal pressure measurement technique based on bladder pressure measurement is a useful procedure which nursing personnel administer and can even be practiced in doctors' offices. This technique is easy, well-known in surgical emergency wards and in reanimation wards; it is minimally invasive, has few side effects and its results can benefit patients; at present time, it is the preferred method to determine intra-abdominal pressure. The authors describe this technique, the materials necessary to administer it, and some of the aforementioned concepts to provide knowledge about abdominal compartment syndrome. Prevention, diagnosis and early measurement of bladder pressure and a timely decompression are the keys to decrease the death rate in patients affected by this syndrome.
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PMID:[How to measure intra-abdominal pressure, the bladder pressure method]. 1904 74

This article focuses primarily on the recent literature on abdominal compartment syndrome (ACS) and the definitions and recommendations published by the World Society for the Abdominal Compartment Syndrome. The definitions regarding increased intra-abdominal pressure (IAP) are listed and are followed by an overview of the different mechanisms of organ dysfunction associated with intra-abdominal hypertension (IAH). Measurement techniques for IAP are discussed, as are recommendations for organ function support and options for treatment in patients who have IAH. ACS was first described in surgical patients who had abdominal trauma, bleeding, or infection; but recently, ACS has been described in patients who have other pathologies. This article intends to provide critical care physicians with a clear insight into the current state of knowledge regarding IAH and ACS.
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PMID:Intra-abdominal hypertension: evolving concepts. 2254 64

"Intra-abdominal hypertension", the presence of elevated intra-abdominal pressure, and "abdominal compartment syndrome", the development of pressure-induced organ-dysfunction and failure, have been increasingly recognized over the past decade as causes of significant morbidity and mortality among critically ill surgical and medical patients. Elevated intra-abdominal pressure can cause significant impairment of cardiac, pulmonary, renal, gastrointestinal, hepatic, and central nervous system function. The significant prognostic value of elevated intra-abdominal pressure has prompted many intensive care units to adopt measurement of this physiologic parameter as a routine vital sign in patients at risk. A thorough understanding of the pathophysiologic implications of elevated intra-abdominal pressure is fundamental to 1) recognizing the presence of intra-abdominal hypertension and abdominal compartment syndrome, 2) effectively resuscitating patients afflicted by these potentially life-threatening diseases, and 3) preventing the development of intra-abdominal pressure-induced end-organ dysfunction and failure. The currently accepted consensus definitions surrounding the diagnosis and treatment of intra-abdominal hypertension and abdominal compartment syndrome are presented.
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PMID:Abdominal compartment syndrome: pathophysiology and definitions. 1925 64

Increased intra-abdominal pressure (IAP) has received growing attention in critically ill patients. Pathophysiologically, it deranges cardiovascular haemodynamics, respiratory and renal functions and may eventually lead to multi-organ failure. It is primarily seen in surgical intensive care units and is frequently associated with abdominal trauma but also occurs after elective abdominal surgery. Non-surgical intensivists ought to be aware that the syndrome is also seen in a wide spectrum of medical conditions, e.g. acute pancreatitis. An expert panel has recently set up definitions of intra-abdominal hypertension (IAH, sustained or repeated pathological elevation in IAP > or = 12 mmHg) and abdominal compartment syndrome (ACS, sustained IAP > 20 mmHg associated with a new organ dysfunction or failure). As clinical signs of IAH are unreliable, IAP should be measured non-invasively by the 'bladder technique'. It is hoped that the consensus definitions will contribute to a broader recognition and effective treatment of this life-threatening syndrome.
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PMID:Abdominal compartment syndrome. 1925 84

The problem of intracavitary hypertension syndromes characterized by similar pathophysiological abnormalities and different etiological factors is investigated and discussed. Compartment syndrome is believed to be the extreme variant of the disease. Specific markers and methods of correction (including surgical intervention) of intracavitory hypertension in critical situations are considered.
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PMID:[Syndrome of intracavitary hypertension in a surgical clinic]. 1928 Sep 82

Severe burns represent a devastating injury that induces profound systemic inflammation requiring large volumes of resuscitative fluids. The consequent massive swelling and peritoneal ascites raises intraabdominal pressures (IAP) to supraphysiologic levels commensurate with intraabdominal hypertension (IAH) and with the abdominal compartment syndrome (ACS) if consistently associated with IAP >20 mmHg and associated with new organ failure. Severe burn injuries are an example of the secondary ACS (secondary ACS), wherein there has been no primary inciting intraperitoneal injury, yet severe IAH/ACS develops, setting the stage for progressive multiorgan dysfunction. These definitions along with practice management guidelines have recently been promulgated by the World Society of the Abdominal Compartment Syndrome (WSACS) in an effort to standardize terminology and communication regarding IAH/ACS in critical care. It is currently unknown whether these syndromes are iatrogenic consequences of excessive or poorly managed fluid resuscitation or unavoidable sequelae of the primary injury. It occurs frequently with burns of >60% body surface area, especially with associated inhalational injury, delayed resuscitation, and abdominal wall injuries. IAH/ACS is often a hyperacute phenomenon that occurs within the first hours of admission and thereafter with any complication requiring aggressive fluid resuscitation. Despite a number of noninvasive management strategies, interventions such as percutaneous peritoneal drainage and, ultimately, decompressive laparotomy are often required once the ACS is established. Whether novel resuscitation strategies can avoid or minimize IAH/ACS is unproven at present and requires further study. Truly understanding postburn ACS may require further insights into the basic mechanisms of injury and resuscitation.
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PMID:Intraabdominal hypertension and the abdominal compartment syndrome in burn patients. 1935 Mar 17

The incidence of intra-abdominal hypertension (IAH) in patients with severe acute pancreatitis (SAP) is approximately 60-80%. It is usually an early phenomenon, partly related to the effects of the inflammatory process, causing retroperitoneal edema, fluid collections, ascites, and ileus, and partly iatrogenic, resulting from aggressive fluid resuscitation. It also can manifest at a later stage, often associated with local pancreatic complications. IAH is associated with impaired organ dysfunction, especially of the cardiovascular, respiratory, and renal systems. Using current definitions, the incidence of the clinical manifestation, abdominal compartment syndrome (ACS), has been reported as 27% in the largest study so far. Despite several intervention options, the mortality in patients developing ACS remains high: 50-75%. Prevention with judicious use of crystalloids is important, and nonsurgical interventions, such as nasogastric decompression, short-term use of neuromuscular blockers, removal of fluid by extracorporeal techniques, and percutaneous drainage of ascites should be instituted early. The indications for surgical decompression are still not clearly defined, but undoubtedly some patients benefit from it. It can be achieved with full-thickness laparostomy (midline or transverse subcostal) or through a subcutaneous linea alba fasciotomy. Despite the improvement in physiological variables and significant decrease in IAP, the effects of surgical decompression on organ function and outcome are less clear. Because of the significant morbidity associated with surgical decompression and the management of the ensuing open abdomen, more research is needed to define better the appropriate indications and techniques for surgical intervention.
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PMID:Intra-abdominal hypertension in acute pancreatitis. 1935 Mar 18

Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have detrimental effects on all organ systems and are associated with significant morbidity and mortality. In recent years, the diagnosis and management of these syndromes has evolved tremendously, and the importance of comprehensive strategies to reduce intraabdominal pressure (IAP) has been recognized. All clinicians should be aware of the risk factors that predict the development of IAH/ACS, the appropriate measurement of IAP, and the current resuscitation options for managing these highly morbid syndromes. The nonoperative management of IAH/ACS can be summarized using five therapeutic goals: evacuate intraluminal contents, evacuate intraabdominal space-occupying lesions, improve abdominal wall compliance, optimize fluid administration, and optimize systemic and regional tissue perfusion. Surgical intervention through open abdominal decompression should immediately be pursued for patients with progressive IAH, end-organ dysfunction, and failure that is refractory to these nonoperative therapies. This comprehensive management strategy has been demonstrated to improve patient survival and long-term outcome.
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PMID:Nonoperative management of intraabdominal hypertension and abdominal compartment syndrome. 1936 90

Surveillance for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) should be implemented in every intensive care unit (ICU), because it has been demonstrated that surveillance is effective. Several criteria that have led to the conclusion that IAH/ACS monitoring is of value: First, IAH is a frequent problem in critically ill patients that directly affects function of all organ systems to some degree, and that is associated with considerable mortality. Furthermore, simple tools for intra-abdominal pressure (IAP) monitoring are available, and it can be safely applied without the need for advanced tools. Finally, both ACS and IAH can be treated with either medical or surgical interventions. Treatment for IAH/ACS should be selected on the basis of the severity of symptoms and the cause of IAH. IAP monitoring should also be incorporated in the daily ICU management of the patient.
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PMID:IAH/ACS: the rationale for surveillance. 1937 8

The increase in intra-abdominal pressure may be followed by a renal, gut, respiratory and cardial dysfunction and an increase in intra-cranial pressure. The review focuses risk factors and pathophysiological consequences of intra-abdominal hypertension and of abdominal compartment syndrome. Patients with intra-abdominal hypertension and abdominal compartment syndrome are critical ill and need special anesthesiological care due to risk of pulmonary aspiration, hemodynamic disturbances and difficult mechanical ventilation.
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PMID:[Intra-abdominal hypertension and abdominal compartment syndrome--basic knowledge and anesthesiological aspects]. 1944 Sep 41


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