Influence of Elevated Intra-abdominal Pressure on Suture Tension Dynamics in a Porcine Model.

Background: Inadequate suture tension is a risk factor for the failure of laparotomy closure. Suture tension dynamics in the abdominal wall are still obscure due to the lack of measuring devices. To answer the questions if intra-abdominal hypertension (IAH) influences suture tension in midline laparotomies and if IAH leads to a permanent loss of suture tension, microsensors were applied in a porcine model of IAH.

The role of abdominal compliance, the neglected parameter in critically ill patients - a consensus review of 16. Part 2: measurement techniques and management recommendations.

The recent definitions on intra-abdominal pressure (IAP), intra-abdominal volume (IAV) and abdominal compliance (Cab) are a step forward in understanding these important concepts. They help our understanding of the pathophysiology, aetiology, prognosis, and treatment of patients with low Cab. However, there is still a relatively poor understanding of the different methods used to measure IAP, IAV and Cab and how certain conditions may affect the results.

Recognition and management of abdominal compartment syndrome among German pediatric intensivists: results of a national survey.

Introduction: Several decades ago, the beneficial effects of goal-directed therapy, which include decompressive laparotomy (DL) and open abdomen procedures in cases of intra-abdominal hypertension (IAH) in children, were proven in the context of closures of abdominal wall defects and large-for-size organ transplantations. Different neonatologic and pediatric disease patterns are also known to be capable of increasing intra-abdominal pressure (IAP). Nevertheless, a considerable knowledge transfer regarding such risk factors has hardly taken place.

Recognition and management of abdominal compartment syndrome among German anesthetists and surgeons: a national survey.

Background: Abdominal compartment syndrome (ACS) is a life threatening condition that may affect any critically ill patient. Little is known about the recognition and management of ACS in Germany.

Methods: A questionnaire was mailed to departments of surgery and anesthesia from German hospitals with more than 450 beds.

Influence of two different levels of intra-abdominal hypertension on bacterial translocation in a porcine model.

Background: The purpose of the present study was to quantify bacterial translocation to mesenteric lymph nodes due to different levels of intra-abdominal hypertension (IAH; 15 vs. 30 mmHg) lasting for 24 h in a porcine model.

Methods: We examined 18 anesthetized and intubated pigs (52.

Abdominal compartment syndrome in childhood: diagnostics, therapy and survival rate.

Purpose: The abdominal compartment syndrome (ACS) in childhood is a rare but dire disease if diagnosed delayed and treated improperly. The mortality amounts up to 60% (Beck et al. in Pediatr Crit Care Med 2:51-56, 2001).

Intraoperative laser fluorescence angiography in colorectal surgery: a noninvasive analysis to reduce the rate of anastomotic leakage.

Purpose: Up to 19% of all colorectal resections develop clinically apparent insufficiencies. Insufficient perfusion of the anastomosis is recognized as an important risk factor. As tissue perfusion can be objectified intraoperatively using laser fluorescence angiography (LFA), its effect on the rate of anastomotic complications was evaluated in a retrospective matched-pairs analysis.

Effects of preserved spontaneous breathing activity during mechanical ventilation in experimental intra-abdominal hypertension.

Purpose: Ventilation problems are common in critically ill patients with intra-abdominal hypertension. The aim of this study was to investigate the effects of preserved spontaneous breathing during mechanical ventilation on hemodynamics, gas exchange, respiratory function and lung injury in experimental intra-abdominal hypertension.

Methods: Twenty anesthetized pigs were intubated and ventilated for 24 h with biphasic positive airway pressure without (BIPAP(PC)) or with additional, unsynchronized spontaneous breathing (BIPAP(SB)).

Histomorphologic and ultrastructural lesions of the pancreas in a porcine model of intra-abdominal hypertension.

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome are increasingly observed in patients with severe acute pancreatitis (SAP). The aim of this study was to investigate the effects of IAH on pancreatic histology and ultrastructure in a porcine model. We examined 16 intubated and anesthetized domestic pigs with a mean body weight of 50.

Direct intra-abdominal pressure monitoring via piezoresistive pressure measurement: a technical note.

Background: Piezoresistive pressure measurement technique (PRM) has previously been applied for direct IAP measurement in a porcine model using two different devices. Aim of this clinical study was to assess both devices regarding complications, reliability and agreement with IVP in patients undergoing elective abdominal surgery.

Methods: A prospective cohort study was performed in 20 patients randomly scheduled to receive PRM either by a Coach-probe or an Accurate(++)-probe (both MIPM, Mammendorf, Germany).

Hernia recurrence after laparotomy: how to close an incised light-weight mesh?

A rising number of patients require relaparotomy after implantation of mesh materials for incisional hernia (IH) repair. No published recommendation concerning how to close the incision in a surgical mesh exists. We describe a central IH recurrence through a partly absorbable mesh positioned in the retromuscular plane 16 months after laparotomy due to a small bowel ileus.

Clinical evaluation of an air-capsule technique for the direct measurement of intra-abdominal pressure after elective abdominal surgery.

Background: The gold standard for assessment of intraabdominal pressure (IAP) is via intravesicular pressure measurement (IVP). This accepted technique has some inherent problems, e.g.

Evaluation of a modified piezoresistive technique and a water-capsule technique for direct and continuous measurement of intra-abdominal pressure in a porcine model.

Objective: Intravesical pressure measurement is considered to be the gold standard for the assessment of intra-abdominal pressure. However, this method is indirect and depends on a physiologic bladder function. We evaluated a modified piezoresistive technique and a water-capsule technique for direct and continuous intra-abdominal pressure measurement.

Physical fitness after apical resection for the treatment of primary spontaneous pneumothorax.

The objective of the present study was to assess the physical fitness of patients after apical resection and partial apical pleurectomy for the treatment of primary spontaneous pneumothorax (PSP). Between 1982 and 1999, 58 patients received surgical treatment for PSP in our department. Twelve patients needed bilateral surgical intervention.

Fluid resuscitation preserves cardiac output but cannot prevent organ damage in a porcine model during 24 h of intraabdominal hypertension.

According to a previous study, a pathologically increased intraabdominal pressure (IAP) reduces cardiac output (CO) and results in medium- to high-grade organ damage in a porcine model of the abdominal compartment syndrome (ACS). The purpose of this study was to evaluate whether fluid resuscitation can preserve organ integrity together with CO. We examined 12 domestic pigs with a mean body weight of 48 kg.

Factors influencing the estimation of extravascular lung water by transpulmonary thermodilution in critically ill patients.

Objective: To investigate factors that may influence the estimation of extravascular lung water (EVLW) with a single (cold) indicator compared with assessment using two indicators (thermo-dye dilution).

Design: Post hoc analysis of an electronic hemodynamic database.

Setting: Surgical intensive care unit of a university hospital.

Intravascular volume depletion in a 24-hour porcine model of intra-abdominal hypertension.

Background: The purpose of the study was to examine hemodynamic parameters and intravascular volume in a porcine model in the presence of intra-abdominal hypertension (IAH) lasting for 24 hours.

Methods: Twelve pigs (52.5 +/- 4.

Evaluation of two novel methods for the direct and continuous measurement of the intra-abdominal pressure in a porcine model.

Objective: Intravesical bladder pressure (IVP) measurement is considered to be the gold standard for the assessment of intra-abdominal pressure (IAP). However, this method is indirect, discontinuous, and potentially infectious and relies on a physiological bladder function. This study evaluated two novel methods for direct, continuous IAP measurement.

A porcine model of the abdominal compartment syndrome.

The purpose of this study was to investigate whether an intra-abdominal pressure (IAP) of 30 mmHg lasting 24 h in a porcine model will lead to a condition comparable with the abdominal compartment syndrome (ACS) in humans. We examined 12 intubated and anesthetized domestic pigs with a mean body weight of 52.5 +/- 4.