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

Abdominal compartment syndrome (ACS) is rarely reported as a complication of severe burn. This study clarified the risk of burned patients with and without ACS, especially regarding the resuscitation fluid volume. Extensively burned patients admitted to our burn unit from January 2003, through to June 2004, were examined. Vital signs, blood gas analysis, bladder pressure to estimate intra-abdominal pressure (IAP), peak inspiratory pressure (PIP), resuscitation fluid volume, and urine output (UO) were analyzed. Intra-abdominal hypertension (IAH) was defined as an IAP of more than 30 cm of H2O. Eight of 48 patients suffering from a more than 30% total burn surface area developed ACS in 18.3+/-4.9 h. In these patients, IAP (49+/-12 cmH2O), PIP (50+/-16 cmH2O), heart rate (115+/-8/min), and PaCO2 (54.6+/-10.1 mmHg) were higher than normal, and their resuscitation volume was 0.40+/-0.11 L/kg. Also, a significant correlation between the IBP, PIP and resuscitation volume was observed. Most patients with severe burns required more than 300 mL/kg of resuscitation fluid for the first 24 h after injury that led to ACS and had higher HR, IBP, PIP and PaCO2 despite arterial pressure showing no significant difference.
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PMID:Resuscitation fluid volume and abdominal compartment syndrome in patients with major burns. 1645 20

Abdominal compartment syndrome (ACS) involves progressive uncontrolled increase in intra-abdominal pressure which eventually leads to multi organ failure. Therefore the ability to diagnose and adequately treat ACS is so important in hospital practice. The aim of this paper was to review current data on intra-abdominal hypertension and ACS, with emphasis on practical aspects. The article presents main concepts, symptoms, causes, pathophysiology and diagnosis of abdominal hypertension and abdominal compartment syndrome (ACS). The article also describes the key elements of contemporary strategy of treatment and prevention of the condition.
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PMID:[Intra-abdominal hypertension and abdominal compartment syndrome--therapeutic implications]. 1688 82

Abdominal compartment syndrome (ACS) is consistently reported to have significant morbidity and mortality. Major burn patients who receive massive fluid resuscitation are at high-risk for this condition. Close monitoring of ACS is necessary for these patients. Prolonged unrelieved intra-abdominal pressure (IAP) at greater than 20 mmHg can produce significant morbidity and mortality. The most widely accepted and feasible way to measure IAP is via the draining port of a standard urinary catheter Siriraj burn unit developed its own device from simple equipment that can be found easily in the hospital. It proved to be useful, cheap, and effective in monitoring intra-abdominal pressure. The present study described techniques of using this device for monitoring and early detection of ACS. Five major burn patients > or = 40% Total body surface area (TBSA) was measured by IAP measurement via foley catheter using the Siriraj device catheter compared to direct measurement via peritoneal catheter. There was no difference of IAP between the two methods (p = 0.48). This suggested that Siriraj device catheter was useful, not invasive, and effective in reflection of actually IAP Siriraj burn unit suggested IAP measurement in all major burns > or = 40% TBSA to early recognize and treat intra-abdominal hypertension(IAH) that can lead to ACS. Early detection of this syndrome might decrease the adverse effects after increasing abdominal pressure that can cause organ dysfunction.
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PMID:Abdominal compartment syndrome monitoring in major burn patients with Siriraj device catheter. 1737 48

Compartment syndrome is a pathophysiological term, comprising a variety of tissues and organ alterations, due to a higher than normal pressure in an anatomically detached space (compartment). In the human body, areas denoted as compartments include the orbital globe, the sub and epidural space, the abdomen, pleura, pericardium, and others. Compartment syndrome was described initially in limbs. Abdominal compartment syndrome is defined as an intra-abdominal pressure above 20 mmHg with evidence of organ failure. Abdominal compartment syndrome develops when the intra-abdominal pressure rapidly reaches certain pathological values, within several hours (intra-abdominal hypertension is observed), and lasts for 6 or more hours. The key to recognizing abdominal compartment syndrome is the demonstration of elevated intra-abdominal pressure which is performed most often via the urinary bladder, and it is considered to be the "gold standard." Multiorgan failure includes damage to the cardiac, pulmonary, renal, neurological, gastrointestinal, abdominal wall, and ophthalmic systems. The gut is the most sensitive to intra-abdominal hypertension, and it develops evidence of end-organ damage before alterations are observed in other systems. The surgical decompression of the abdomen remains the treatment of choice of abdominal compartment syndrome; this usually improves the organ changes, and is followed by one of the temporary abdominal closure techniques in order to prevent secondary intra-abdominal hypertension.
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PMID:Abdominal compartment syndrome. 1808 56

Abdominal compartment syndrome (ACS) is a life-threatening syndrome that is increasing in incidence amongst critically ill patients. A 2005 survey of critical care nurses revealed that there were recognised knowledge deficits of ACS amongst surveyed nurses. The purpose of this review is to inform critical care nurses about ACS and its antecedent, intra abdominal hypertension (IAH). Detection techniques, causes, clinical manifestations and pathophysiology of IAH and ACS will be outlined and medical and nursing management will be reviewed. The incidence of ACS is reported to be up to 35% in the intensive care population with reduced survival when compared to other intensive care patients. Physiological changes that occur with ACS include compromise to the cardiovascular, respiratory, renal and neurological systems and development of metabolic acidosis. Management may incorporate percutaneous drainage of ascitic fluid, use of muscle relaxants, prone positioning and surgical intervention to open, decompress and gradually close the abdomen. Throughout this care the critical care nurse should ensure accurate monitoring of organ function, assessment for recurrence of ACS as well as the amount and type of drainage, appropriate wound management and provision of physical and psychosocial support of the patient. These aspects of care have the potential to impact significantly on patient outcome.
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PMID:A critical care nurse's guide to intra abdominal hypertension and abdominal compartment syndrome. 1820 94

Abdominal compartment syndrome was initially described as a cascade of physiopathological events triggered by the increase in intra-abdominal pressure induced by a surgical procedure for aneurysm of the abdominal aorta. In practice, it is a complication that can arise after various procedures; it has a multi-organ impact and can lead to exitus. We retrospectively analyzed a total of 9 patients with abdominal compartment syndrome. In 5 cases onset of the syndrome was due to a secondary complication of a vascular procedure (3 mesenteric, 2 renal). The clinical data characterizing the disease included abdominal distension and reduced diuresis. In all cases the finding of increased necrosis scores (LDH, CPK) was evident, while the appearance of leukocytosis occurred only in 4 (44%). The basic treatment was surgical decompression. In one case we obtained an excellent result with medical treatment alone, consisting in steroids and PGE1; these were useful in all cases in which an inflammatory bowel component played a role. Our experience encourages us to stress the importance of early assessment of abdominal hypertension in patients with a potential risk of abdominal compartment syndrome. In this phase, appropriate medical and supportive treatment could limit the surgical indications or at any rate favour the healing process after surgical decompression, the basic treatment indicated for this syndrome.
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PMID:Abdominal compartment syndrome: a situation thet needs to be better known. 1870 76

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 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.
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PMID:[Abdominal compartment syndrome]. 1884 92

Abdominal compartment syndrome (ACS) occurs in critically ill patients for surgical, as well as medical reasons. It implies significant mortality. Therefore diagnostic vigilance and agressive treatment are necessary. All patients at elevated risk of ACS should have their intraabdominal pressure monitored, which is best measured in the urinary bladder. The currently adopted borderline of intra-abdominal hypertension is 12 mmHg and of ACS -20 mmHg, if it is accompanied by abdominal or thoracic organ insufficiency. The gold standard of quick and definitive treatment of ACS is surgical decompression by opening the abdomen and leaving it open until intraabdominal pressure decreases. Dressings with aspiration of abdominal fluid seem the most helpful, although prospective studies are necessary. The methods of non-operation decompression are a good alternative, when intraabdominal pressure is lower and in oncological patients.
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PMID:[Abdominal compartment syndrome--current recommendations]. 1914 Mar 89

Abdominal compartment syndrome is a lethal yet under appreciated complication of vascular surgery. The World Society of Abdominal Compartment Syndrome conference in 2004 culminated recent research to formulate the internationally accepted definitions and promote education, in an attempt to reduce a quoted 82% mortality. The syndrome has a broad aetiology, many of which are pertinent to vascular surgery and particularly to ruptured aortic aneurysms. It is defined as an intra-abdominal pressure greater than 12 mm Hg or an abdominal perfusion pressure less than 60mm Hg, in the presence of end organ dysfunction and ultimately leads to multi-organ failure. The physiological derangements which occur in all major organ systems are generally well documented and an understanding of them paramount to early recognition. Numerous methods have been devised to measure intra-abdominal pressure and ideally, measurements utilising a catheter and pressure transducer should be taken in high risk patients yet very few clinicians have measured it. This is essential for diagnosis and also allows grading of the hypertension as clinical and radiological examination does not provide any conclusive information. Appropriate post operative wound closure has an important role in prevention of the syndrome, which would otherwise be treated by surgical decompression. Negative pressure dressings appear to be most beneficial but further prospective trials are required to clarify this.
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PMID:Abdominal compartment syndrome in vascular surgery - A review. 2007 77

In recent years, significant interest has been observed in intra-abdominal hypertension and abdominal compartment syndromes. Intra-abdominal pressure (IAP) has been defined as a static pressure between organs in the abdominal cavity. Continuous or recurrent increase in the IAP above 12 mm Hg (1.6 kPa) is regarded as abdominal hypertension (IAH). Among the most common causes of IAH are massive fluid resuscitation after major injuries or burns, and ischemia of intestines after major vascular surgery. Abdominal compartment syndrome has been defined as a continuous intra-abdominal pressure above 20 mm Hg (2.67 kPa) with coexisting organ dysfunction or failure. The mortality of patients with recognized abdominal compartment syndrome may be as high as 42%. Diagnosis of intra-abdominal hypertension is based on the measurement of IAP only. The World Society of the Abdominal Compartment Syndrome (WSACS) has been advising screenings of IAP in all patients admitted to intensive care units with certain risk factors. As a standard measurement of IAP, the pressure in the bladder filled maximally with 25 mL of sterile normal saline is accepted. IAP should be measured at the end-expiratory phase, in the flat supine position, after relaxation of abdominal muscles and referred to the median axillary line as a zero-level. In confirmed cases of IAH and/or ACS, immediate action should be taken. It consists of evacuation of gastric and bowel contents, maintenance of adequate blood pressure, diuretics and/or ultrafiltration, and ultimately deeper sedation and/or muscle relaxation. Surgical percutaneous evacuation of the fluid or a decompression laparotomy may be considered.
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PMID:[Measurement of the intra abdominal pressure in clinical practice]. 2141 38


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