Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Abdominal compartment syndrome (ACS) is a well-recognized perioperative complication that occurs in patients who undergo intra-abdominal operations and who require extensive fluid resuscitation. The classic presentation of this syndrome includes high peak airway pressures; oliguria, despite adequate filling pressures; and intra-abdominal pressures of more than 25 mm Hg. A decompressive laparotomy performed at the bedside can alleviate ACS. If left untreated, sustained intra-abdominal hypertension is often fatal. In the literature, ACS has been described in pediatric patients with burns but not in adult patients with burns. This article describes 3 adults who sustained burns of more than 70% of their body surface areas, who required more than 20 L of crystalloid resuscitation, and who developed ACS during their resuscitation after the burn injury. The mortality rate among these patients was 100%, which confirms the grave consequences of this syndrome. In our institution, intra-abdominal pressure is now routinely measured as part of the burn resuscitation process in an attempt to diagnose and treat this syndrome earlier and more efficaciously. It is recommended that the possibility of ACS be considered when diagnosing any patient with burns who develops high airway pressures, oliguria, or both.
 ...
PMID:Abdominal compartment syndrome in patients with burns. 1085 Sep 14

Abdominal compartment syndrome refers to a complex of negative effects of intra-abdominal hypertension. Its most common cause is complicated abdominal trauma. The syndrome includes mainly hemodynamic and respiratory manifestations but may involve other systems as well. It may present as a life-threatening emergency in the multi-trauma patient. Awareness of the syndrome may enable the surgeon to take preventive measures or to diagnose it earlier and to treat it effectively. We describe a 21-year old man who developed this syndrome after multiple gunshot wounds, with severe liver injury. After 2 operations the typical manifestations of the syndrome were diagnosed. He was re-operated to release intra-abdominal hypertension and then slowly recovered.
 ...
PMID:[Abdominal compartment syndrome]. 1090 50

In the last few years, physiological changes, symptoms, diagnostic tools, and treatment of abdominal compartment syndrome interest surgeons, trauma surgeons and anaesthetists. Sudden, dangerous basic vital function deterioration in patients managed in the intensive care unit, may be results of abdominal compartment syndrome. Abdominal compartment syndrome is secondary to massive intraabdominal haemorrhages, hepatic or retroperitoneal space "packing", fluid collection in tissues, including abdominal organs. Circulatory, respiratory and kidney dysfunction occur, when intraabdominal pressure measured in urinary bladder is 25 H2O or higher. In this condition, rapid surgical decompression is necessary. During decompression abdominal organs reperfusion may produce arterial hypotension and asystole. Abdominal closure must prevent abdominal hypertension. Temporary plastic patch, simple and cheap is the most popular technique.
 ...
PMID:[Abdominal compartment syndrome: current view]. 1160 85

Abdominal compartment syndrome (ACS) is defined by the deleterious effects of intraabdominal hypertension (IAH) on the pulmonary, cardiovascular, splanchnic, urinary and central nervous system. Abnormal and sudden increase in the volume of any component of the intraperitoneal or retroperitoneal space (occurRing postoperatively or subsequent to hemorrhagic trauma, referfusion edema, penumoperitoneum, intestinal distention, acute pancreatitis...) causes IAH. Sustained IAH leads to ACS which if left unrecognized or untreated is always fatal. Measurement of urinary bladder pressure is the best validated technique for diagnosis of IAH. It should be used routinely for minimally invasive surveillance of intra-abdominal pressure (IAP) in patients with severe thoraco-abdominal trauma or after major abdominal operations. Medical management of IAH is of limited efficacy making expedient surgical decompression the treatment of choice for ACS. Surgical decompression of the abdomen and temporary closure is generally recognized as effective in clinically patent ACS but the pressure threshold indicating the need for decompression remains controversial. No data are available from controlled randomized trials and current guidelines are based on the experience of large trauma centers. The few available prospective clinical series report survival rates in the 38 to 71% range after surgical decompression for ACS. These studies are difficult to compare due to methodological features but it would appear that centers using the lowest pressure threshold for decompensation (< 20 mmHg) have the highest survival rates. Despite the available physiological arguments, indications for prophylactic temporary abdominal coverage (TAC), e.g. in trauma patients or for early decompression in IAH patients without clinical ACS, have not been validated in clinical practice. The potential morbidity of decompression procedures, TAC, and subsequent abdominal wall reconstructions require comparative studies of these treatment options with available pharmacological and non-surgical means to lower IAP.
 ...
PMID:[Abdominal compartment syndrome]. 1189 89

Compartment syndrome is classically considered a complication of a musculoskeletal injury. Recent research has confirmed the abdomen as a potential compartment with the capability to cause life-threatening local and systemic manifestations. Abdominal compartment syndrome (ACS) is precipitated by an acute increase in abdominal contents volume with resulting intraabdominal hypertension. Presenting signs of ACS include a firm tense abdomen, increased peak inspiratory pressures, and oliguria, all of which improve after abdominal decompression. Patients at risk for ACS include trauma (blunt or open), retroperitoneal hemorrhage, massive fluid resuscitation, pancreatitis, pneumoperitoneum, and neoplasm. Surgical decompression is the treatment of choice. The perianesthesia nurse plays a critical role in the team managing a patient at risk for abdominal compartment syndrome through intraabdominal pressure monitoring, wound care, and end organ perfusion support.
 ...
PMID:Abdominal compartment syndrome: a case review. 1247 8

Abdominal compartment syndrome is a potentially lethal condition caused by any event that produces intra-abdominal hypertension; the most common cause is blunt abdominal trauma. Increasing intra-abdominal pressure causes progressive hypoperfusion and ischemia of the intestines and other peritoneal and retroperitoneal structures. Pathophysiological effects include release of cytokines, formation of oxygen free radicals, and decreased cellular production of adenosine triphosphate. These processes may lead to translocation of bacteria from the gut and intestinal edema, predisposing patients to multiorgan dysfunction syndrome. The consequences of abdominal compartment syndrome are profound and affect many vital body systems. Hemodynamic, respiratory, renal, and neurological abnormalities are hallmarks of abdominal compartment syndrome. Medical management consists of urgent decompressive laparotomy. Nursing care involves vigilant monitoring for early detection, including serial measurements of intra-abdominal pressure.
 ...
PMID:Pathophysiology and management of abdominal compartment syndrome. 1288 69

Abdominal compartment syndrome is a well-documented entity arising from multiple and various causes. The rise of intra-abdominal pressure by the increase in volume of the peritoneal and retroperitoneal contents has been shown in the resuscitation and evaluation of surgical patients. However, the incidence of constriction of the abdomen causing intra-abdominal hypertension is unknown. Previously limited to burn eschar and externally applied devices (such as MAST trousers), external compression leading to abdominal compartment syndrome has been a limited entity. We report the first documented case of an expansive abdominal wall mass, a rectus sheath hematoma, leading to impending abdominal compartment syndrome.
 ...
PMID:Abdominal compartment syndrome as a consequence of rectus sheath hematoma. 1462 59

Abdominal compartment syndrome resulting from intra-abdominal hypertension can be prevented or treated with the formation of a laparostomy. In the majority of cases this is followed by delayed abdominal wall reconstruction involving the use of prosthetic materials and split-skin grafts. The authors present a case study involving a patient who underwent repair of a ruptured abdominal aortic aneurysm and required a laparostomy to prevent abdominal compartment syndrome. He also had significant perioperative morbidity and poor nutritional status. Despite this, satisfactory wound healing was achieved without the need for split-skin grafting, thus avoiding further surgery and its associated complications.
 ...
PMID:Laparostomy healing by secondary intention after ruptured abdominal aortic aneurysm repair. 1476 31

The pressure within the abdominal cavity is normally little more than atmospheric pressure. However, even small increases in intra-abdominal pressure can have adverse effects on renal function, cardiac output, hepatic blood flow, respiratory mechanics, splanchnic perfusion and intracranial pressure. Although intra-abdominal pressure can be measured directly, this is invasive and bedside measurement of intra-abdominal pressure is usually achieved via the urinary bladder. This cheap, easy approach has been shown to produce results that correlate closely with directly measured abdominal pressures. Significant increases in intra-abdominal pressure are seen in a wide variety of conditions commonly encountered in the intensive care unit, such as ruptured aortic aneurysm, abdominal trauma and acute pancreatitis. Abdominal compartment syndrome describes the combination of increased intra-abdominal pressure and end-organ dysfunction. This syndrome has a high mortality, most deaths resulting from sepsis and multi-organ failure. Detection of abdominal compartment syndrome requires close surveillance of intra-abdominal pressure in patients thought to be at risk of developing intra-abdominal hypertension. The only available treatment for established abdominal compartment syndrome is decompressive laparotomy. Prevention of abdominal compartment syndrome after laparotomy by adoption of an open abdomen approach may be preferable in the patient at significant risk of developing intra-abdominal hypertension, but this has not been demonstrated in any large trials. Most surgeons prefer to adopt a 'wait and see' policy, only intervening when clinical deterioration is associated with a significant increase in intra-abdominal pressure.
 ...
PMID:Intra-abdominal hypertension and the abdominal compartment syndrome. 1531 Mar 55

A 70-year-old man with clinically localised prostate carcinoma underwent extraperitoneal endoscopic radical prostatectomy. His medical history revealed hypertension, renal colic, hypogonadotropic hypogonadism and recurrent deep venous thrombosis in the legs. The operation was uneventful with 500 ml blood loss and no periods ofhypotension. The patient developed oliguria within 12 h after surgery. A hypovolemic state was initially suggested to explain the oliguria and increasing amounts of intravenous fluids were administered. The oliguria persisted, however, and the patient did not respond to a diuretic. There was no fluid loss in the drain. Blood pressure, pulse and temperature were normal. Peritonitis and bowel perforation were excluded. Ultrasound examination of the bladder and kidneys revealed an empty bladder and no dilatation of the upper urinary tract, which excluded a post-renal obstruction. The clinical situation deteriorated within hours as the patient developed anuria, bowel distension, metabolic acidosis with progressive renal failure and signs of respiratory distress for which mechanical ventilation was needed. A chest X-ray prior to intubation did not show pneumonia or signs indicating pulmonary embolism. CT of the abdomen was performed to evaluate urinary leakage but revealed no fluid collection or urinoma. Thus pre- and post-renal causes of oliguria were excluded. In view of the systemic symptoms, intra-abdominal pressure was measured using a bladder catheter; it varied between 25 and 35 cm water. Together with the clinical situation, a diagnosis of abdominal compartment syndrome was made and coeliotomy was performed immediately. Within 10 min after decompression of the peritoneal cavity, diuresis started spontaneously. Renal function was restored to preoperative levels in 3 weeks. Abdominal compartment syndrome is a potentially life-threatening cause of anuria. The syndrome should be part of the differential diagnosis for patients with postoperative anuria, including those who underwent extraperitoneal minimally invasive procedures.
 ...
PMID:[Clinical reasoning and decision-making in practice. A patient with oliguria following prostatectomy]. 1637 15


1 2 3 4 Next >>