Abstract
The importance of elevated intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) have been recognized in critical care for its potential damaging effects. But, quantification of IAP values may be useful as a clinical tool for determining efficacy of coughing and straining for functional recovery of OA patients. We would like to evaluate IAP generated in an OA patient and the effect of negative pressure therapy (NPT) and dynamic abdominal closure systems (ABRA) on the IAP values at rest and during coughing and straining and compare those with IAP measurements of closed abdomen after standard open elective colorectal surgery (non-OA). Eight OA and eight non-OA patients were included in this study. OA patient with NPT and ABRA (OA + NA), OA patient without NPT and ABRA completely unbraced (OA-NA) (NA stands for NPT and ABRA), and non-OA patients underwent IAP measurements at rest, during coughing, and during straining via transurethral catheter. There was no difference in the mean of IAP measurement at rest in OA-NA (6.1 mmHg), OA + NA (6.5 mmHg), and non-OA (6.0 mmHg) patients. During coughing, IAP of OA-NA, OA + NA, and non-OA patients were 11.5, 19.1, and 22.0 mmHg and during straining, IAP of OA-NA, OA + NA, and non-OA patients were 11.5, 17.5, and 23.5 mmHg, respectively. Application of NPT in conjunction with ABRA did not increase IAP at rest but provided significant IAP increase in OA + NA patients, when compared to OA-NA patients during coughing and straining. NPT in conjunction with ABRA offers the advantage of increase of IAP during coughing and straining.
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References
Kirkpatrick AW, Roberts DJ, De Waele J, Jaeschke R, Malbrain ML, De Keulenaer B et al (2013) Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med 39:1190–1206
A. Hecker,B. Hecker,M. Hecker,J. G. Riedel,M. A. Weigand,W. Padberg. Acute abdominal compartment syndrome: current diagnostic and therapeutic options.Langenbeck’sArchieves of Surgery doi:10.10007/s00423-015-1353-4.
Salman AE, Yetişir F, Aksoy M, Tokaç M, Yildirim MB, Kiliç M (2014) Use of dynamic wound closure system in conjunction with vacuum-assisted closure therapy in delayed closure of open abdomen. Hernia 18:99–104
Yetişir AE, Salman R, Mamedov M, Aksoy A, Yalcin C (2014) KayaalpIntrarectal negative pressure system in the management of open abdomen with colorectal fistula: a case reportInt. J Surg Case Rep 5:164–168
Plaudis H, Rudzats A, Melberga L, Kazaka I, Suba O (2012) Abdominal negative pressure therapy: a new method in countering abdominal compartment and peritonitis—prospective study and critical review of literature. Ann Intensive Care 2(suppl1):S23
Kirkpatrick AW, Roberts DJ, Faris PD et al (2015) Active negative pressure peritoneal therapy after abbreviated laparotomy. The intraperitoneal vacuum randomized controlled trial. Ann Surg 262:38–46
Addington W, Stephens R, Phelipa M et al (2008) Intraabdominal pressures during voluntary and reflex cough. Cough 4:2
Cobb WS, Burns JM, Kercher KW, Matthews BD, Norton HJ, Heniford BT (2005) Normal intraabdominal pressure in healthy adults. J Surg Res 129:231–235
Iqbal A, Haider M, Stadlhuber RJ, Karu A, Corkhill S, Filipi CJ (2008) A study of intragastric and intravesicular pressure changes during rest, coughing, weight lifting, retching, and vomiting. Surg Endosc 22:2571–2575
Stokes IAF, Gardner-Morse MG, Henry SM (2010) Intraabdominal pressure and wall muscular function:spinal unloading mechanism. ClinBiomech (Bristol, Avon) 25(9):859–866
Venturi ML, Attinger CE, Meshabi AN, Hess CL, Graw KS (2005) Mechanisms and clinical applications of the vacuum-assistedclosure (VAC) device: a review. Am J Clin Dermatol 6(3):185–194
Kubiak BD, Albert SP, Gatto LA, Snyder KP, Maier KG, Vieau CJ, Roy S, Nieman GF (2010) Peritoneal negative pressure therapy prevents multiple organ injury in a chronic porcine sepsis and ischemia/reperfusion model. Shock 34:525–534
Jacobs S, Simhae DA, Marsano A, Fomovsky GM, Niedt G, WuJK (2009) Efficacy and mechanism of vacuum assisted closure(VAC) therapy in promoting wound healing: a rodent model. J Plast Reconstr Aesthet Surg 62:1331–1338
De Waele JJ, Kaplan M, Sugrue M, SibajaP,BjörckM.How to deal with an open abdomen? Anesthesiology intensive therapy ISSN 0209–1712
16.Yetisir F, Salman AE, Kaya O. Dynamic abdominal wall closure for open abdomen.Manual of ICU procedures.MohanGurjar, Jaypee Brothers Medical Publishers.1st edition 2016.
Yetisir F, Sarer AE, Acar HZ, Aygar M (2015) Delayed closure of 61 open abdomen patients based on an algorithm. Indian J Surg 1–7
Yetişir F, Salman AE, Aygar M, Yaylak F, Aksoy M, Yalçin A (2014) Management of fistula of ileal conduit in open abdomen by intra-condoit negative pressure systemInt. J Surg Case Rep 9:385–388
Yetisir F, Sarer AE, Acar HZ, Ciftciler E (2015) The reversal of stoma following open abdomen management. Indian J Surg. doi:10.1007/s12262-015-1336-2
19.Cohen WA, Horovitz JH, Kupfer Y, Savel RH.The complex surgical abdomen:What the nonsurgeon intensivist needs to know?Journal of Intensive care med 2015 Jan 30. pii: 088506661556997
Leppaniemi A, Kimball EJ, De laet I, Malbrain MLNG, Balogh ZJ, De Waele JJ (2015) Management of abdominal sepsis—a paradigm shift? Anesthesology Intensive Ther 47(4):400–408
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Sarer, A.E., Yetisir, F., Aygar, M. et al. Intra-abdominal Pressure Monitoring in Open Abdomen Management with Dynamic Abdominal Closure. Indian J Surg 79, 384–389 (2017). https://doi.org/10.1007/s12262-016-1491-0
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DOI: https://doi.org/10.1007/s12262-016-1491-0