Intra-abdominal Pressure Measurement Research Articles

Intracranial Hypertension and Intra-abdominal Pressure. Is it Worth Measuring?

AbstractPatients with refractory intracranial hypertension who have already undergone all the measures recommended by the current guidelines can benefit from having their intra-abdominal pressure monitored since its increase generates hemodynamic repercussions and secondary elevation of intracranial pressure. In this context, a bibliographic research was performed on PubMed with the terms intra-abdominal pressure, abdominal compartment syndrome, intracranial pressure, intracranial hypertension. Altogether, 146 articles were observed, 87 of which were from the year 2000, and only 15 articles were considered relevant to the topic. These studies indicate that patients with refractory intracranial hypertension can benefit from the measurement of intraabdominal pressure, since there is evidence that an increase in this pressure leads to organic dysfunctions with an indirect impact on cerebral venous return and, consequently, an increase in intracranial pressure. In those who underwent decompression laparotomy, direct effects were observed in reducing intracranial hypertension and survival.

Intra-abdominal Pressure Measurements Using a Wireless Radio Pressure Pill and Two Wire Connected Pressure Transducers: A Comparison

Intra-abdominal pressures were measured simultaneously with a wireless radio pill and two wire-connected pressure transducers introduced orally and rectally respectively. Measurements were made on 8 men during common postures, simple activities and static and dynamic lifting. An acceptable correspondence was found in wave forms of the generated pressure curves in time and shape. The three systems showed, however, a less good agreement in recorded peak differences, i.e. highest and lowest pressure responses to each task. The radio pill is simple to use, but more difficult to calibrate and expensive, compared to the wire-connected methods, which however are less attractive for use in the work environment.

Respiratory consequences of intra-abdominal hypertension.

Intra-abdominal hypertension (IAH) is a common complication in critically ill patients that may lead to multiorgan failure and is associated to worse outcome. Respiratory failure is among the most important consequences of IAH and it is originated by different mechanisms, such as chest wall elastance increase, functional residual capacity reduction, compression atelectasis and lung edema formation through reduction in lymphatic drainage. Many experimental studies showed that total lung capacity and functional residual capacity can be decreased by 40% during abdominal hypertension, while respiratory system and chest wall pressure-volume curves can be significantly shifted downward and to the right. Moreover, the relationship between intra-abdominal volume and airway pressure has been found to be exponential, meaning that small increases in volume can translate in dramatic increases in pressure. Clinical studies confirmed relevant atelectasis in dependent lung regions during IAH, with significant reductions in functional residual capacity and compromised oxygenation. Moreover, sepsis-related capillary leak and fluid overload may aggravate IAH and respiratory failure, thus establishing a dangerous vicious circle. Respiratory management of patients with IAH is challenging and there is no univocal answer. The measurement of intra-abdominal pressure and esophageal pressure (as a surrogate of pleural pressure) may be useful in assessing the condition and guiding mechanical ventilation. Positive end-expiratory pressure (PEEP) must be carefully selected to counteract IAH-related diaphragm displacement, but too high PEEP levels are associated with hemodynamic failure. Continuous negative extra-abdominal pressure is a promising approach, but its clinical application needs more investigation.

Intra-abdominal Pressure Screening of Horses With Colic

The objective of this study was to evaluate changes in intra-abdominal pressure (IAP) in horses with colic by associating the underlying etiologies with directly acquired IAP values and survival rate. This is a 2-year cohort study (2014–2016). Horses with clinical signs of colic were admitted to the veterinary teaching hospital during the period 2014–2016. Twenty-eight horses, of different breeds, males (stallions and geldings) and females, aged between 2 and 20 years, and weighing from 300 to 450 kg presenting with clinical signs of colic, were included in the study. IAP was directly acquired at the right flank (standing under sedation) and at the linea alba (supine position under general anesthesia). Twenty IAP measurements were recorded at end expiration for each recording site. IAP values >0.0 mmHg, obtained at the upper right flank in the standing position, were associated with surgical treatment (P < .05). In these cases, signs of colic were associated with strangulated obstructions of the large colon, and a greater likelihood of death as a result of colic (P < .001). Intra-abdominal pressure varied considerably in horses with colic, even for the same underlying etiologies. Horses with colic related to strangulating obstructions of the large intestine had IAP >.0 mmHg, at the upper right flank. These horses were also considerably more likely to require surgical intervention (P < .05) and death/euthanasia was more likely in this group of horses (P < .001).

Factors associated with increased intra-abdominal pressure in patients undergoing cardiac surgery.

The aim of this study was to investigate the intra-abdominal pressure changes and risk factors associated with increased intra-abdominal pressure in patients undergoing cardiac surgery. Between July 2016 and January 2017, a total of 100 patients (74 males, 26 females; mean age 55.9±14.3 years; range, 19 to 75 years) who underwent cardiac surgery under cardiopulmonary bypass were included in the study. Patients" data including demographic and clinical characteristics and intra- and postoperative data were recorded. Intra-abdominal pressure was measured via a urinary catheter after anesthesia induction, on admission to the intensive care unit, and at postoperative 12 and 24 h. The patients were divided into two groups according to the intraabdominal pressure as Group 1 (≥12 mmHg; n=49) and Group 2 (<12 mmHg; n=51). In the univariate regression analysis, high intra-abdominal pressure was related to intra-abdominal pressure measured after anesthesia induction (Odds Ratio =0.70, p=0.001), age (odds ratio=0.95, p=0.004), hypertension (odds ratio=4.51, p=0.0001), duration of cardiopulmonary bypass (odds ratio=0.97, p=0.0001), intraoperative lactate levels (odds ratio=0.53, p=0.0001), use of red blood cells (odds ratio=0.24, p=0.0001), use of dopamine (odds ratio=0.21, p=0.002), dobutamine (odds ratio=0.28, p=0.005), use of noradrenaline (odds ratio=0.25, p=0.016), postoperative lactate levels (odds ratio=0.60, p=0.0001), duration of cross-clamp (odds ratio=0.97, p=0.0001), atrial fibrillation (odds ratio=5.89, p=0.004), and acute kidney injury (odds ratio=8.33, p=0.048). In the multivariate analysis, the intra-abdominal pressure at baseline (odds ratio=0.70, p=0.045), age (odds ratio=0.93, p=0.032), hypertension (odds ratio=6.87, p=0.023), duration of cardiopulmonary bypass (odds ratio=0.98, p=0.062), intraoperative lactate levels (odds ratio=0.57, p=0.035), and use of red blood cells (odds ratio=0.19, p=0.003) remained statistically significant. Our study results suggest that age, hypertension, duration of cardiopulmonary bypass, intraoperative lactate levels, and use of red blood cells are risk factors associated with elevated intra-abdominal pressure in patients undergoing cardiac surgery. Increased awareness of these risk factors and the addition of intra-abdominal pressure measurement to the standard follow-up scheme in patients with variable hemodynamics, low cardiac output, and high lactate levels in the intensive care unit may be useful in early diagnosis of complications and in decreasing morbidity.

Postoperative pulmonary complications in robot-assisted uro-oncological surgeries: Our experience in a tertiary cancer care centre.

Postoperative pulmonary complications in robot-assisted uro-oncological surgeries: Our experience in a tertiary cancer care centre.

Intra-abdominal hypertension assessment based on Near Infra-Red reflectometry: New model and low-cost device

This work describes a simple optical model of the abdominal wall for non-invasive assessment of intra-abdominal pressure during laparoscopy, and the optimized design of a low-cost device for clinical measurements. A pilot run performed on a cadaver of a Sus scrofa domesticus (domestic pig) is case-studied for validation of a proposed rule-of-thumb design. Intra-abdominal hypertension was induced by inflating the abdomen. An inverse correlation between intra-abdominal pressure and Near Infra-Red (NIR) reflectometry measurements verified the model. Previous work claimed that changes in NIR reflectometry, during intra-abdominal hypertension, depended on the oxygenation of the abdominal wall tissues. However, in our work on a cadaver, oxygenation is not relevant; therefore, we conclude that the changes in NIR reflectometry are connected to changes in the thickness and density of the abdominal wall due to hypertension, confirming the proposed rule-of-thumb design for a new device.

Incidence of Intra-Abdominal Hypertension and Abdominal Compartment Syndrome: A Systematic Review

To determine the contemporary prevalence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome in critically ill patients. Medline, Embase, and Central databases. Studies reporting on the prevalence of IAH in consecutively admitted critically ill patients using the World Society of Abdominal Compartment Syndrome (WSACS) consensus guidelines for intra-abdominal pressure (IAP) measurement. Duplicate independent review and data abstraction. The search identified 2428 titles with 6 eligible studies (n = 1965). Reported prevalence ranged from 30% to 49%. Despite abiding by the WSACS guidelines for IAP measurement, studies varied in their definition of IAH, frequency and duration of IAP measurement, and reporting of outcomes. Three of 6 studies reported that IAH, especially at higher grades, was an independent predictor of mortality. Intra-abdominal hypertension is a common finding in critically ill patients and may be associated with increased mortality, especially at higher grades. Further prospective research is required to examine the effect of screening and treatment of IAH on patient outcomes.

Intra-abdominal Pressure Changes During Hip Arthroscopy: A Prospective Multicenter Study

To evaluate intra-abdominal pressure changes during hip arthroscopy and define its relationship with other patient related variables. A prospective multicenter study evaluating intra-abdominal pressure (IAP) in patients undergoing arthroscopic treatment of femoroacetabular impingement was performed. The IAP was measured indirectly by a bladder catheter (AbViser Autovalve Intra-abdominal pressure monitor) and documented every 30 minutes during the entire procedure. The following risk factors were analyzed: traction time, duration surgery, previous abdominal surgery, capsule repair, psoas tenotomy, and surgical approach. One hundred and five patients with symptomatic femoroacetabular impingement that underwent hip arthroscopy met the inclusion criteria. There were significant differences in the IAP between the preoperative measurement of IAP and the IAP at different time points during surgery (P<.01). The IAP increased continuously from the commencement of surgery (considered as time point from portal establishment) until the first 60 minutes. After first 60 minutes of surgery, the IAP did not increase significantly. There were no significant associations between increased IAP and the risk factors analyzed. IAP increases significantly during the first 60 minutes of hip arthroscopy; it then stabilizes for the duration of surgery before decreasing just after the completion of surgery. The highest recorded IAP was not associated with additional complications. No symptomatic intra-abdominal hypertension was documented. Finally, patient- and procedure-specific risk factors did not predict changes in IAP. Systemic monitoring of IAP during the hip arthroscopy procedure can easily and effectively be done, allowing the surgeon to early detect any significant change. Level IV, therapeutic case series.

GASTROINTESTINAL INSUFFICIENCY SYNDROME IN INTENSIVE CARE OF NEWBORN: LITERATURE REVIEW

The research analytical study of scientific publications in Cochrane Library, Medline, Scopus, Pubmed, Google Scholar databases for the period from 2008 to 2018 was conducted. Modern views on the course of critical states are increasingly considering this process as the uniform mechanism with universal pathogenetic links that lead to the formation of multiple organ lesions, including the digestive system lesions. The contingent of newborns is the patients of high risk of this syndrome occurrence. The frequency of gastrointestinal insufficiency in neonatology makes 80%. The anatomical and functional features of newborns contribute to the development of the syndrome of gastrointestinal insufficiency. There is no clear classification, diagnostic and treatment algorithm of this syndrome. The residual stomach volume measurements when feeding, the abdominal circumference and intraabdominal pressure measurements are used as markers of gastrointestinal insufficiency syndrome in newborns. The additional methods are available X-ray, dopplerographia, electrogastrographia, manometria, phonenterographia, the studies of the fatty-acid-binding proteins, zonulin, β-defensins, calprotectin. The therapy of the gastrointestinal insufficiency syndrome in newborns include the evacuation of pathological intestinal content, detoxification, stimulation of intestinal motility, elimination of mesenteric blood flow violations, restoration of the intestinal microbiota, adequate energoplastic and cyto-energy homeostasis.

Evaluation and Management of Abdominal Compartment Syndrome in the Emergency Department.

Abdominal compartment syndrome is a potentially deadly condition that can be missed in the emergency department setting. The purpose of this narrative review article is to provide a summary of the background, pathophysiology, diagnosis, and management of abdominal compartment syndrome with a focus on emergency clinicians. Abdominal compartment syndrome is caused by excessive pressure within the abdominal compartment due to diminished abdominal wall compliance, increased intraluminal contents, increased abdominal contents, or capillary leak/fluid resuscitation. History and physical examination are insufficient in isolation, and the gold standard is intra-abdominal pressure measurement. Abdominal compartment syndrome is defined as an intra-abdominal pressure >20mm Hg with evidence of end-organ injury. Management involves increasing abdominal wall compliance (e.g., analgesia, sedation, and neuromuscular blocking agents), evacuating gastrointestinal contents (e.g., nasogastric tubes, rectal tubes, and prokinetic agents), avoiding excessive fluid resuscitation, draining intraperitoneal contents (e.g., percutaneous drain), and decompressive laparotomy in select cases. Patients are critically ill and often require admission to a critical care unit. Abdominal compartment syndrome is an increasingly recognized condition with the potential for significant morbidity and mortality. It is important for clinicians to be aware of the current evidence regarding the diagnosis, management, and disposition of these patients.

Dynamic ultrasound examination of intestinal failure syndrome in patients with severe combined trauma

Objective: to identify ultrasound (US) signs of intestinal failure syndrome (IFS) in patients with combined trauma and to determine their compliance with the clinical classification of IFS. In the process of dynamic ultrasound monitoring in 18 patients on the 5–7th day, gastrointestinal motility recovered with a decrease in intra-abdominal pressure (IAP) to normal, which corresponded to stage I of IIS. In 12 patients, gastrostasis and expansion of the small intestine, an increase in the linear blood flow velocity in the portal vein up to 30 cm/sec, IAP up to 20 mm Hg were observed which corresponded to stage II of IFS. On the 15–20th day, 3 patients with stage III of IFS recovered gastrointestinal motility, 9 patients died due to multiple organ failure. Ultrasound revealed an increase in the liver and spleen with portal hypertension, edema of the walls of the small and large intestines was observed, intra-abdominal pressure increased, which corresponded to stage III of intestinal failure.Results. The results of ultrasound in dynamics with an assessment of the morphological and functional state of the gastrointestinal tract confirm their compliance with the stages of the clinical classification of intestinal failure syndrome. With the help of ultrasound with dopplerography and measurement of IAP, it was possible to objectify the clinical classification of intestinal failure syndrome.

Nurses' knowledge-attitude-practice status on early enteral nutrition of critically ill patients in Class III Grade A hospitals

Objective To explore the current status of nurses' knowledge, attitude and practice in Class Ⅲ Grade A hospitals on early enteral nutrition in critically ill patients. Methods A total of 114 nurses in a Class Ⅲ Grade A hospital in Beijing were selected by convenience sampling method on March of 2019. Self-designed Nurses' Knowledge, Attitude and Practice Questionnaire on Early Enteral Nutrition in Critically Ill Patients was used to investigate the nurses, and the contents included their general information and their related knowledge, attitude, practice towards the critically ill patient's early enteral nutrition. Results Nurses scored 5.00-85.00 points on Nurses' Knowledge Questionnaire on Early Enteral Nutrition in Critically Ill Patients, with a median of 35.00 points; Attitude Questionnaire scored 0.00-80.00 points, with a median of 80.00 points; Practice Questionnaire scored (51.49±13.18) points, ranging from 13.33 to 83.33 points; 27.19% of nurses had never received relevant knowledge training. Conclusions Nurses should have comprehensive knowledge of early enteral nutrition for severely ill patient to enable patients receive more effective enteral nutrition support, pay attention to the clinical application of pyloric retroperitoneal feeding technology, integrate dynamic nutrition screening and intra-abdominal pressure measurement into routine nursing work, and find out the exist problems of early enteral nutrition in severely ill patients in time, improve the quality of holistic nursing, so that severely ill patients can get the most effective enteral nutrition support. Key words: Intensive Care Unit; Early enteral nutrition; Nurses; Knowledge, attitude, practice

Inpatient Evaluation of Intra-abdominal Pressure Completed With a Urinary Catheter as Compared With Ultrasonographic Vessel Measurements

Background: The purpose of this study was to evaluate the diagnostic value of ultrasonography as compared with intra-abdominal pressure (IAP) measured with a urinary catheter. Methods: This was a cross-sectional study. The participants consisted of 146 patients hospitalized in the emergency wards of two hospitals in Isfahan (2017-2018). Following measurement of IAP through a urinary catheter, ultrasonographic measurement of the inferior vena cava (IVC) diameter, internal jugular vein diameter, common femoral vein (CFV) diameter, and ratio between the IVC and abdominal aortic diameters was completed. Correlation between these methods of measurements for IAP was investigated. Results: There was a significant positive correlation between intrabladder pressure and the right internal jugular vein (RIJV) and CFV ( P &lt; .001, R &gt; 0). There was also a reverse significant correlation between intrabladder pressure and RIJV, IVC, IVC:aorta diameter, systolic blood pressure, and tricuspid annular plane systolic excursion ( P &lt; .001, r &lt; 0). RIJV, CFV, and tricuspid annular plane systolic excursion were suitable predictors for the estimation of intrabladder pressure or IAP ( P &lt; .05), but IVC, IVC:aorta, and systolic blood pressure were not suitable factors for estimating IAP ( P &gt; .05). Conclusion: Ultrasonographic measurement is a noninvasive method for determining IAP.

“INTRAABDOMINAL HYPERTENSION AND ABDOMINAL COMPARTMENT SYNDROME IN EMERGENCY LAPAROTOMY PATIENTS IN TERTIARY CARE RURAL HOSPITAL”

Background: Although initially recognized over 150 years ago, the patho-physiologic implications of elevated intra-abdominal pressure (IAP) have essentially been rediscovered only within the past two decades. The aim of the study was to evaluate the incidence, morbidity and mortality of intra abdominal hypertension and abdominal compartment syndrome in emergency laparotomy patients in tertiary care rural hospital.&#x0D; Method: IAP measurement was done in all patients undergoing emergency laparotomy with manometry technique (U tube technique) using per- urethral foley's catheterization.&#x0D; Results: Our study population was a group of patients who underwent laparotomy for various indications which included traumatic as well as non-traumatic causes. In total, 104 patients, with 30 females and 74 males were included in the study population who fulfilled the study criteria. The mean ± SD age in our study were 40.2±13 years with 20-30yrs being the most common age group. Most of the studies on IAH and ACS analyse either trauma or ICU patients. Little has been reported on ACS in general surgical population. Our study population was a group of patients who underwent laparotomy for various indications which included traumatic as well as non traumatic causes, hence a predominance of general surgical patients.&#x0D; Conclusions: Findings suggest that the incidence of ACS in our study is 3.84 % and found to be more common in trauma patients. There is significant association between increased Intra-abdominal pressure at 6 and 24 hours after laparotomy and organ dysfunction. The total mortality rate in ACS group was 75%. There is significant association between increased Intra-abdominal pressure and mortality.

Severe pancreatitis complicated by abdominal compartment syndrome managed with decompressive laparotomy: a case report

BackgroundAbdominal compartment syndrome (ACS) is an uncommon complication of severe pancreatitis. It is defined as a sustained intraabdominal pressure (IAP) > 20 mmHg (with or without an abdominal perfusion pressure (APP) < 60 mmHg), associated with new organ dysfunction/failure. ACS confers a poor prognosis and should be promptly diagnosed and managed. However, it is often missed on clinical examination, leading to a delay of diagnosis.Case presentationA 38-year old Sri Lankan man presented with severe alcohol-induced pancreatitis associated with abdominal compartment syndrome. Diagnosis was delayed due to false reassurance from clinical examination. The patient was managed with a decompressive laparotomy, after which he required treatment with continuous renal replacement therapy (CRRT), total parenteral nutrition (TPN) and broad-spectrum antibiotics for a prolonged period of time. Despite significant post-operative multi-organ failure, the patient survived.ConclusionsEarly trans-bladder measurement of IAP is important for severe pancreatitis. Serial measurements of IAP should be implemented early when any known risk factor for ACS is present in a critically ill patient.

Investigation of the inter-dependence between intra-abdominal pressure and spinal stability

IntroductionMany researchers have explored the link between intra-abdominal pressure and the biomechanical stability of the spine. Children severely affected with cerebral palsy have low engagement of the abdominal region and correspondingly very poor spine stability. Rehabilitation programs often seek to improve such resources, but a link has never been objectively demonstrated in this patient population who may greatly benefit from potential gains. Thus, the purpose is to evaluate the interdependency between intra-abdominal pressure and spinal stability in cerebral palsy patients undergoing a targeted rehabilitation program. MethodsA non-randomized prospective cohort treatment study of patients with gross motor function classification system types 4 and 5 over five years old while undergoing a high-frequency rehabilitation program targeting spinal stability. Blinded measures of intra-abdominal pressure and seated spinal stability were acquired. All measures were taken at baseline and bi-annually for 2 years. GMFCS classification were taken at baseline to distinguish the study group. Study directives were approved by independent ethical committees. Non-parametric Wilcoxon tests were utilized to perform data analyses. FindingsMeasures of intra-abdominal pressure, by way of customized indentometer, improved from 3.23 to 4.46 lbs./in. of compression between baseline and 24 months (p < 0.05). Seated spinal stability improved from scores of 2.3 to 3.1 after 24 months (p < 0.05). Results showed a trend of collinearity between intra-abdominal pressure and seated spinal stability. InterpretationResults suggest a correlation between intra-abdominal compression and, correspondingly, better seated spinal stability for GMFCS class 4 and 5 patients.

ASSESSMENT OF INFERIOR VENA CAVA DIAMETER MEASURED BY ULTRA-SONOGRAPHY IN CORRELATION WITH CENTRAL VENOUS PRESSURE VALUE IN PATIENTS WITH SEPSIS

Background: Bedside ultrasound is potentially a useful noninvasive adjunct to estimate the intravascular volume status in sepsis. Aim of the work: Evaluating the correlation between inferior vena cava diameter measured non-invasively with ultrasonography versus central venous pressure in assessment of intravascular volume status in patients with sepsis.Patients and methods: The study was conducted on sixty patients with sepsis (30 ventilated and 30 non-ventilated) in the Respiratory Intensive Care Unit at Abbassia Chest Hospital from January 2018 to September 2018. For all included patients demographic data were collected Recording vital sings, mean arterial pressure and Pao2/ Fio2were done. Laboratory investigation including complete blood count, serum lactic acid, arterial blood gas, quantitative C-reactiveprotein were also done. Sequential Organ Failure Assessment score (SOFA), Qsofa and Acute Physiology And Chronic Health Evaluation II score (APACHE II) were recorded. Finally measurement of IVC, CVP and intra-abdominal pressure were done Results: Males represent 75%while female were 25%withmean age of (47.40±14.49) years. The mean CVP was 12.48±3.78 cmH2O with an IVC maximum diameter of 17.95±3.28 mm and collapsibility index of 50.55±11.83 %. There was statistically significant positive correlation between CVP and IVC dmax and statistically significant negativecorrelation between CVP and IVC CI (%)in both ventilated and non ventilated groups. Also, CVP and IVC dmax were significantly correlated with outcome in both ventilated and non ventilated patients. The higher values of CVP and IVC dmax and the lower the value of IVC CI, the higher rates of mortality. Conclusion: US assessment of IVC diameter and caval index are simple and non invasive methods to assess intravascular volume status.

Diagnosis and Choice of a Method of Treatment of Intraabdominal Hypertension and Abdominal Compartment Syndrome

BACKGROUND: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) remain a complex problem of abdominal surgery. To date, the pathophysiological mechanisms, methods for determining intra-abdominal pressure (IAP) the frequency of its measurement, and the methods of conservative and surgical more and more researchers consider surgical decompression as a treatment.&#x0D; AIMS: Аnalysis of the results of the implementation of monitoring of intra-abdominal pressure and its impact on the outcomes of treatment of patients with severe acute pancreatitis and acute colon obstruction.&#x0D; MATERIALS AND METHODS: A study of 397 patients with emergency abdominal pathology including 197 with acute obstructive obstruction of the colon (AOOC), 200 severe acute pancreatitis (SAP) was performed. Patients (n=201) were included in the I (main) group, which was carried out using IAP as the main criterion for assessing the patient`s condition and when choosing a method of treatment, in II ― without taking then into account and monitoring. Measurement of IAP, blood lactate was determined primarily, then alternatively 4 to 6 hours. The survey included the study of biochemical indicators, endoscopic methods, visualization (ultrasound scanning, CT of the abdominal cavity organs).&#x0D; RESULTS: In the I group of IAH patients, I and II degrees were in 73.13%, in the II group in 79.5% IAH III and IV degrees, respectively, in 26.87% and 21.5% (p0.05). Measurement of IAP was carried out according to the I.L. Kron method, repeated measurement depending on the degree of IAH after 46 hours, simultaneously, as a predictor of internal ischemia, determined the level of lactate in blood and perfusion abdominal pressure. An algorithm for early diagnosis is suggested excess intraabdominal pressure. For I and II, the degree of IAH was treated with aggressive conservative therapy, with failure of intensive therapy III of IAH degree surgical treatment, with IV degree IAH emergency decompressive laparotomy. In the I group, the mortality was significantly lower than in the II group: IAH at III, with AOOC 27.7% and 50%, respectively (p0.05), at SAP 37.5% and 80% (p0.01), respectively, at IV degree IAH for AOOC 75% and 90% (p0.05), with SAP 75% and 88,8% (p0.05) respectively.&#x0D; CONCLUSIONS: The results of treatment of patients with IAH can be improved by its early diagnosis, intensive, aggressive therapy of IAH IIII degrees. At IAH I, II degrees conservative treatment is shown, persistent aggressive conservative treatment should be performed at IAH III degree, if it is unsuccessful and IV degree of IAH, an emergency decompressive laparotomy should be performed.

The Relationship Between Intra-Abdominal Pressure and Body Acceleration During Exercise.

High intra-abdominal pressure (IAP) may influence the development of pelvic floor disorders. We and others have used intravaginal pressure transducers to measure IAP in women during exercise and daily activities, but utilizing the transducer for long-term measurements creates compliance issues. Waist-worn accelerometers are prominent in research and may be a reliable alternative for approximating IAP. We hypothesized that there are pair-wise positive correlations between the mean maximal accelerometer vector magnitude and 2 IAP measurements: mean maximal IAP and area under the curve (AUC). Twenty-five women who regularly participated in exercise performed 13 activities. Intra-abdominal pressure was measured with an intravaginal transducer and acceleration with a waist-worn accelerometer. We determined the mean maximal IAP, AUC for IAP, and mean maximal accelerometer vector magnitude for each activity and participant. The relationship between IAP and acceleration was determined by computing the Pearson correlation coefficient (R) and the 95% confidence interval for mean maximal accelerometer vector magnitude versus mean maximal IAP and mean maximal accelerometer vector magnitude versus AUC for IAP. The R values were 0.7353 for mean maximal accelerometer vector magnitude versus mean maximal IAP (including walking) and 0.5059 for mean maximal accelerometer vector magnitude versus AUC for IAP (excluding walking). Walking at 3 speeds, analyzed separately, presented R values of 0.72208 for mean maximal IAP and 0.21678 for AUC. Waist-worn accelerometers may provide a viable method for approximating mean maximal IAP in a population of women during most activities.