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Analyzing intra-abdominal pressures and outcomes in patients undergoing emergency laparotomy.

Khan S, Verma AK, Ahmad SM, Ahmad R - J Emerg Trauma Shock (2010)

Bottom Line: No significant association was found between IAP and occurrence of burst abdomen (P > 0.1).Elevated IAP was found to affect all the organ systems adversely.IAH has detrimental effects on various organ systems.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, J. N. Medical College, AMU, Aligarh-202002, Uttar Pradesh, India.

ABSTRACT

Background: Studies have documented the impact of intra-abdominal hypertension (IAH) on virtually every organ. However, it still remains strangely underdiagnosed. The aims of the study were to assess, in patients undergoing emergency laparotomy, whether intra-abdominal pressure (IAP) is an independent predictor of morbidity and mortality, to evaluate the effects of IAH, and to identify hidden cases of abdominal compartment syndrome (ACS).

Materials and methods: The study comprised 197 patients undergoing emergency laparotomy. IAP was measured preoperatively and then postoperatively at 0, 6, and 24 hours. Duration of hospital stay, occurrence of burst abdomen, and mortality were noted as outcomes.

Results: At admission, incidence of IAH was 80%. No significant association was found between IAP and occurrence of burst abdomen (P > 0.1). IAP was found to be a significant predictor of mortality in patients undergoing laparotomy (P < 0.001). Elevated IAP was found to affect all the organ systems adversely. The incidence of post-op ACS was 3.05% in the general population and 13.16% in trauma patients. The mortality rate for this subgroup was 100%.

Conclusions: IAP is a significant predictor of mortality in patients undergoing laparotomy. IAH has detrimental effects on various organ systems. A more frequent monitoring with prompt decompression may be helpful in decreasing the mortality rate. Further studies are required to establish a screening protocol in patients undergoing laparotomy to detect and manage cases of IAH and ACS.

No MeSH data available.


Related in: MedlinePlus

Incidence of IAH
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Figure 0001: Incidence of IAH

Mentions: No IAH was observed at 0 hours post-op. Post-op (6 hours) IAP grading is as shown in Table 2. Incidence of IAH is shown in Figure 1.


Analyzing intra-abdominal pressures and outcomes in patients undergoing emergency laparotomy.

Khan S, Verma AK, Ahmad SM, Ahmad R - J Emerg Trauma Shock (2010)

Incidence of IAH
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2966562&req=5

Figure 0001: Incidence of IAH
Mentions: No IAH was observed at 0 hours post-op. Post-op (6 hours) IAP grading is as shown in Table 2. Incidence of IAH is shown in Figure 1.

Bottom Line: No significant association was found between IAP and occurrence of burst abdomen (P > 0.1).Elevated IAP was found to affect all the organ systems adversely.IAH has detrimental effects on various organ systems.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, J. N. Medical College, AMU, Aligarh-202002, Uttar Pradesh, India.

ABSTRACT

Background: Studies have documented the impact of intra-abdominal hypertension (IAH) on virtually every organ. However, it still remains strangely underdiagnosed. The aims of the study were to assess, in patients undergoing emergency laparotomy, whether intra-abdominal pressure (IAP) is an independent predictor of morbidity and mortality, to evaluate the effects of IAH, and to identify hidden cases of abdominal compartment syndrome (ACS).

Materials and methods: The study comprised 197 patients undergoing emergency laparotomy. IAP was measured preoperatively and then postoperatively at 0, 6, and 24 hours. Duration of hospital stay, occurrence of burst abdomen, and mortality were noted as outcomes.

Results: At admission, incidence of IAH was 80%. No significant association was found between IAP and occurrence of burst abdomen (P > 0.1). IAP was found to be a significant predictor of mortality in patients undergoing laparotomy (P < 0.001). Elevated IAP was found to affect all the organ systems adversely. The incidence of post-op ACS was 3.05% in the general population and 13.16% in trauma patients. The mortality rate for this subgroup was 100%.

Conclusions: IAP is a significant predictor of mortality in patients undergoing laparotomy. IAH has detrimental effects on various organ systems. A more frequent monitoring with prompt decompression may be helpful in decreasing the mortality rate. Further studies are required to establish a screening protocol in patients undergoing laparotomy to detect and manage cases of IAH and ACS.

No MeSH data available.


Related in: MedlinePlus