Intra-abdominal hypertension / Manu Malbrain, Jan De Waele.

Format:

Book

Author/Creator:

Malbrain, Manu, 1965- author.

Waele, Jan de, author.

Series:

Core critical care.

Core critical care

Language:

English

Subjects (All):

Abdomen--Diseases.

Abdomen.

Compartment syndrome.

Physical Description:

1 online resource (xiv, 240 pages) : digital, PDF file(s).

Edition:

1st ed.

Place of Publication:

Cambridge : Cambridge University Press, 2013.

Summary:

Despite increasing interest in intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) as causes of significant morbidity and mortality among the critically ill, unanswered questions cloud the understanding of the pathophysiology of these conditions: • Are IAH and ACS synonymous? • What are the ideal methods of measuring and lowering intra-abdominal pressure (IAP)? • When should we think of IAH? • Can IAH be prevented? • What level of IAP requires abdominal decompression? Written by two experts in critical care and IAP, Intra-Abdominal Hypertension is a distillation of the current literature and furthers the understanding of these complex critical conditions. Using a step-by-step approach and illustrative figures, this clinical handbook presents a concise overview of consensus definitions, measurement methods, organ assessment and treatment options. Intra-Abdominal Hypertension is essential reading for all members of the intensive care multidisciplinary team, including experienced and junior physicians, anesthetists and nurses.

Contents:

Cover

Contents

Contributors

Abbreviations

Foreword

Section 1 Understanding intra-abdominal hypertension: what to worry about?

Chapter 1 What is intra-abdominal pressure?

Introduction

(Very) brief history of IAP

The abdominal wall

Basics of fluid physics - all about pressure

The relation between IAP and IAV - compliance and elastance

Key points

Further reading

Chapter 2 Definitions

Background

Definitions

Definition 1 - IAP

Definition 2 - abdominal perfusion pressure (APP)

Definition 3 - filtration gradient (FG)

Definition 4 - units of measurements and reference

Definition 5 - reference standard

Definition 6 - normal IAP

Definition 7 - IAH

Definition 8 - IAH grades

Definition 9 - ACS

Definition 10 - primary ACS

Definition 11 - secondary ACS

Definition 12 - recurrent ACS

The future of the definitions

Chapter 3 Principles of IAP management

Measure IAP at the end of expiration

IAP is (usually) measured in the bladder

IAP can be measured through routes other than the bladder

IAP can be measured with fluid-filled or air-filled systems

IAP should be measured against a reference level

Instillation of fluid in the bladder is required

The temperature of the instillation fluid should be controlled

The patient's body position is important

Supine versus semi-recumbent position

Prone position

Other positions

The effect of positive end expiratory pressure (PEEP) on IAP

Chapter 4 Systems available to measure IAP

Clinical estimation of IAP

Measurement of IAP is safe

Measurement of IAP is reproducible

Routes for IAP measurements

Transvesicular route

Transgastric route

Alternative routes

Modalities of IAP measurements.

Available methods for IAP measurement

Intermittent IAP measurement

Transvesicular: FoleyManometerTM or Uno-Meter Abdo-PressureTM

Transvesicular: Harahill method

Transvesicular: AbViserTM IAP Monitoring Kit

Transvesicular: Bard IAP® Monitoring Device

Transvesicular: Biometrix

Transvesicular: PreOx IAP Adapter

Transgastric: gastric tube or Collee method

Transgastric: gastric balloon method

Continuous IAP measurement

Continuous transvesicular IAP measurement

Continuous IAP monitoring - CiMON (Pulsion Medical Systems)

The IAP-Catheter and IAP-Monitor (Spiegelberg)

Chapter 5 Pitfalls of IAP monitoring

The pitfalls

Pitfalls related to the patient

Positioning of the patient

The awake patient

Intra-abdominal space-occupying lesions

Obesity

Children

Pitfalls related to the measurement technique

Zero reference level

Gastric route

Infusion volume

Infusion temperature

Frequency of IAP measurement

Pitfall specific to the kit used

Pitfalls related to the interpretation of data

Section 2 Underlying predisposing conditions: when to worry?

Chapter 6 Decreased abdominal compliance

What is abdominal compliance?

Why is abdominal compliance important?

Implications for clinical practice

How does decreased abdominal wall compliance lead to IAH?

Is this clinically important?

Can I and should I measure abdominal compliance in my patient?

How do I know when abdominal wall compliance is decreased?

How do I know when abdominal wall compliance is increased?

Chapter 7 Increased abdominal content

Measuring IAV

IAV in clinical practice

Is IAV relevant?

IAV and primary IAH

IAV and secondary IAH.

Other ways in which IAV has an impact on IAH

Chapter 8 Capillary leak and fluid resuscitation

Capillary dynamics

Capillary leak in the critically ill patient

IAP and the three hits model of shock

The ebb phase

The flow phase

The global increased permeability syndrome

When it starts to get better (day 3)

Section 3 Specific conditions: when to worry more?

Chapter 9 Pancreatitis

Why and when do patients with severe acute pancreatitis develop IAH and ACS?

Consequences of IAH and ACS in the patient with severe acute pancreatitis

Diagnosis of IAH and ACS in the patient with severe acute pancreatitis

Prevention of IAH and ACS in the patient with severe acute pancreatitis

Treatment of IAH and ACS in the patient with severe acute pancreatitis

Surgery

Feeding

When can the clinician stop considering IAH in patients with severe acute pancreatitis?

Chapter 10 Children

IAP in children

Normal values of IAP in children

Measurement of IAP in children.

Outcomes of IAP in children

IAH and ACS in children

Diagnosis of IAH and ACS in children

Management of IAH and ACS in children

Chapter 11 Trauma

Types of ACS in trauma patients

Incidence

The 'bloody' vicious circle and IAH

Conservative management of the patient with abdominal trauma

IAH in the patient with an open abdomen

Chapter 12 Burns

Consequences of IAH in the patient with severe burns

Monitoring IAP in the burn patient

IAH prevention in the burn patient

Urine output as an indicator during resuscitation of the burn patient.

Treatment of IAH in the burn patient

Chapter 13 Obesity

Normal values of IAP in obese patients

IAP and chronic morbidity in the obese patient

Systemic hypertension

Pseudotumour cerebri

Respiratory morbidity

Gastro-oesophageal reflux

Incisional hernia

Specifics of IAP management in the obese patient

Chapter 14 Pregnancy and others

Pregnancy and IAP

Peritoneal dialysis and IAP

IAP during iatrogenic pneumoperitoneum

IAP in the haematological patient

Any other conditions leading to IAP?

Gastroenterology

Respiratory

Neurology

Cardiology

Gynaecology

Reconstructive surgery

Orthopaedics

Miscellaneous

Section 4 Consequences of intra-abdominal hypertension: why to worry?

Chapter 15 Cardiovascular system and IAH

Pathophysiology

Overall cardiovascular effects of IAH

IAH and preload

IAH and contractility

IAH and afterload

Filling pressures are inaccurate with IAH

What about volumetric monitoring?

Abdominal perfusion pressure (APP)

IAP and responsiveness to fluid

Chapter 16 Respiratory system and IAH

IAH and acute lung injury

IAH and lung distension

IAH and pulmonary oedema

IAP and mechanical ventilation

IAP and pulmonary hypertension

Chapter 17 Renal system and IAH

Critical IAP in relation to renal function

The impact of IAH-induced kidney failure

Implications for clinical management

Diagnosis of AKI in patients with IAH?

Prevention of IAH-induced kidney injury?

How do I treat the patient with IAH-induced AKI?

Key points.

Further reading

Chapter 18 Central nervous system and IAH

How does IAH lead to intracranial hypertension?

Importance of the impact of IAH on ICP

Conditions associated with increased IAP and ICP

Prevention of IAH-induced raised ICP

Treatment of IAH when ICP is raised

Chapter 19 Other organs and IAH

The liver and IAH

Gastrointestinal function and IAH

The abdominal wall and IAH

Endocrine function and IAH

Chapter 20 How to define gastrointestinal failure?

Multiple organ dysfunction syndrome

IAH as a marker of gastrointestinal dysfunction

Chapter 21 Polycompartment syndromes

Abdominal compartment syndrome

Other compartment syndromes

Hepatic compartment syndrome

Renal compartment syndrome

Pelvic compartment syndrome

Cardiac compartment syndrome

Intracranial compartment syndrome

Intraorbital compartment syndrome

Limbs or extremity compartment syndrome

Polycompartment syndrome

Section 5 Treatment

Chapter 22 Improvement of abdominal wall compliance

Decreased abdominal wall compliance leads to IAH

Measuring abdominal compliance

Preventing decreased C-abd

Increasing abdominal wall compliance

Chapter 23 Evacuation of intraluminal contents

How do intraluminal contents lead to IAH?

Ileus and IAH

Enteral feed

Evacuation of intraluminal content

Surgical intervention

Chapter 24 Evacuation of abdominal fluid collections

What are the causes of abdominal fluid collections leading to IAH?.

What about more factors leading to IAH or ACS?.

Notes:

Title from publisher's bibliographic system (viewed on 05 Oct 2015).

Includes bibliographical references at the end of each chapters and index.

ISBN:

1-316-09060-4

1-107-27215-7

1-107-27496-6

1-107-27699-3

1-107-27373-0

1-107-27822-8

0-511-66701-9

OCLC:

854975196