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Journals / Ulusal Travma ve Acil Cerrahi Dergisi / 2013 / Cilt: 19 - Sayı: 6

Can increased intra-abdominal pressure (IAP) be treated more effectively with intravesical pressure measurement in high-risk patients?

Karıniçi basınç artışına yol açabilen hastalıkların tedavisi intravezikal basınç ölçümü kontrolü altında daha güvenle yapılabilir mi?

Emre DİVARCI
MUSTAFA ORKAN ERGÜN
Bülent KARAPINAR
MEHMET YALAZ
AHMET ÇELİK
Pages
559–563
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Similarly, IVP monitoring can facilitate the closure of abdominal wall defects and the application of fluid resuscitation in septic shock.

📌 3 Key Takeaways

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Objective & Hypothesis:BACKGROUND: Increased intra-abdominal pressure (IAP) can result in multiorgan failure.
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Key Findings & Data:Trauma, mechanical bowel obstruction (MBO), abdo- minal wall defects (AWD) and fluid resuscitation in septic shock are conditions associated with a high risk of increased IAP in children.
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Conclusion & Impact:Similarly, IVP monitoring can facilitate the closure of abdominal wall defects and the application of fluid resuscitation in septic shock.
🔬Design:Research Article
📍Scope:2009 Verileri
⚙️Variables:Domain Parameters

Abstract

BACKGROUND: Increased intra-abdominal pressure (IAP) can result in multiorgan failure. Trauma, mechanical bowel obstruction (MBO), abdo- minal wall defects (AWD) and fluid resuscitation in septic shock are conditions associated with a high risk of increased IAP in children. It may be possible to treat these conditions more effectively using intravesical pressure measurement. METHODS: This prospective study was performed between December 2009 and October 2010. Intravesical pressure (IVP) measurement was used to determine IAP. The presence of Intra-abdominal hypertension (IAP >12 mmHg) and abdominal compartment syndrome (IAP >15 mmHg + new organ dysfunction) was evaluated in all clinical decisions. RESULTS: IVP monitoring was applied in all patients with abdominal trauma (14), AWD (8), fluid resuscitation for septic shock (7), and MBO (6). A diagnosis of ACS was determined in 14% of trauma patients and required surgery. IAH/ACS occurred in 38% of AWD cases, which required closure. IAH occurred in 43% of patients undergoing fluid resuscitation for septic shock, requiring decompressive intervention. IAH/ACS occurred in 50 % of MBO patients, all of whom required surgery. CONCLUSION: IVP measurement is a useful method to identify candidates for surgical treatment in cases of trauma and MBO. Similarly, IVP monitoring can facilitate the closure of abdominal wall defects and the application of fluid resuscitation in septic shock.

Özet

AMAÇ: Karıniçi basınç artışına bağlı ilerleyici organ yetersizliği gelişebilmektedir. Travma, adheziv ileus, karın ön duvarı defektleri ve septik şokta sıvı resüsitasyonu çocukluk çağında karıniçi basınç artışına neden olabilen hastalıklardan bazılarıdır. Bu hastalıkların tedavisi karıniçi (intraabdominal) basınç (İAB) ölçümü kontrolü altında daha güvenle yapılabilir mi? GEREÇ VE YÖNTEM: Aralık 2009 - Ekim 2010 tarihleri arasında ileriye yönelik bir çalışma uygulandı. İAB saptanmasında intravezikal basınç (İVB) ölçümü kullanıldı. Tedavi stratejilerinin belirlenmesinde karıniçi hipertansiyon (İAB >12 mmHg) ve abdominal kompartman sendromu (İAB >15 mmHg + yeni gelişen organ disfonksiyonu) eşik değerler olarak kullanıldı. BULGULAR: Abdominal travma (n=14), karın ön duvarı defektleri (n=8), septik şokta sıvı resüsitasyonu (n=7) ve adheziv ileuslu (n=6) 35 hasta çalışmaya alındı. Travmalı hastaların %14’ünde AKS saptandı ve cerrahi gerekti. İAH/AKS karın ön duvarı defektli has- taların %38’inde defektin kapatılması sonrasında saptandı ve kapatma stratejileri değiştirildi. Septik şokta sıvı resüsitasyonu sırasında hastaların %43’ünde İAH gözlendi ve dekompresif girişimler uygulandı. İAH/AKS saptanan adheziv ileuslu üç hastada (%50) cerrahi girişim kararında basınç yüksekliklerinin katkısı oldu. SONUÇ: İntravezikal basınç ölçümü, izlem ve tedavileri sırasında İAB artışına yol açabilen hastalıkların tedavilerinin yönlendirilmesi ve girişim gerekliliğinin karar verilmesinde önemli katkılar sağlayabilmektedir. Riskli hastalık gruplarında İVB ölçümü, kolay ve güvenle uygulanabilecek yardımcı bir yöntemdir.

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Cite This Article

DİVARCI, E., ERGÜN, M. O., KARAPINAR, B., YALAZ, M., ÇELİK, A. (2013). Can increased intra-abdominal pressure (IAP) be treated more effectively with intravesical pressure measurement in high-risk patients?. Ulusal Travma ve Acil Cerrahi Dergisi, Cilt: 19 - Sayı: 6, 559–563. https://ajindex.com/articles/324141

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