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Prophylactic open abdomen in patients with postoperative intra-abdominal hypertension

Postoperative intra-abdominal hypertension (IAH) is a frequent occurrence in critically ill patients operated on for severe abdominal trauma, secondary peritonitis or ruptured abdominal aortic aneurysm. IAH may progress to abdominal compartment syndrome (ACS) with new-onset organ dysfunction. Early...

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Detalles Bibliográficos
Autores principales: Mentula, Panu, Leppäniemi, Ari
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2875490/
https://www.ncbi.nlm.nih.gov/pubmed/20156323
http://dx.doi.org/10.1186/cc8207
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author Mentula, Panu
Leppäniemi, Ari
author_facet Mentula, Panu
Leppäniemi, Ari
author_sort Mentula, Panu
collection PubMed
description Postoperative intra-abdominal hypertension (IAH) is a frequent occurrence in critically ill patients operated on for severe abdominal trauma, secondary peritonitis or ruptured abdominal aortic aneurysm. IAH may progress to abdominal compartment syndrome (ACS) with new-onset organ dysfunction. Early recognition of IAH and interventions that prevent the development of ACS may preserve vital organ functions and increase the probability of survival. The best method to prevent postoperative ACS is to leave the abdomen open during the operation. The decision to leave the abdomen open is usually based on the surgeon's judgment without intra-abdominal pressure (IAP) measurements during the operation. Because significant morbidity and mortality are associated with the open abdomen, the measurement of IAP immediately after the fascial closure, when feasible, could offer an objective method for determining the optimal IAP threshold for leaving the abdomen open. The management of the open abdomen requires a temporary abdominal closure (TAC) system that would ideally prevent the development of ACS and facilitate later primary fascia closure. Among several TAC systems, the most promising are those that provide negative pressure to the wound or continuous fascial traction or both.
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spelling pubmed-28754902011-02-04 Prophylactic open abdomen in patients with postoperative intra-abdominal hypertension Mentula, Panu Leppäniemi, Ari Crit Care Commentary Postoperative intra-abdominal hypertension (IAH) is a frequent occurrence in critically ill patients operated on for severe abdominal trauma, secondary peritonitis or ruptured abdominal aortic aneurysm. IAH may progress to abdominal compartment syndrome (ACS) with new-onset organ dysfunction. Early recognition of IAH and interventions that prevent the development of ACS may preserve vital organ functions and increase the probability of survival. The best method to prevent postoperative ACS is to leave the abdomen open during the operation. The decision to leave the abdomen open is usually based on the surgeon's judgment without intra-abdominal pressure (IAP) measurements during the operation. Because significant morbidity and mortality are associated with the open abdomen, the measurement of IAP immediately after the fascial closure, when feasible, could offer an objective method for determining the optimal IAP threshold for leaving the abdomen open. The management of the open abdomen requires a temporary abdominal closure (TAC) system that would ideally prevent the development of ACS and facilitate later primary fascia closure. Among several TAC systems, the most promising are those that provide negative pressure to the wound or continuous fascial traction or both. BioMed Central 2010 2010-02-04 /pmc/articles/PMC2875490/ /pubmed/20156323 http://dx.doi.org/10.1186/cc8207 Text en Copyright ©2010 BioMed Central Ltd
spellingShingle Commentary
Mentula, Panu
Leppäniemi, Ari
Prophylactic open abdomen in patients with postoperative intra-abdominal hypertension
title Prophylactic open abdomen in patients with postoperative intra-abdominal hypertension
title_full Prophylactic open abdomen in patients with postoperative intra-abdominal hypertension
title_fullStr Prophylactic open abdomen in patients with postoperative intra-abdominal hypertension
title_full_unstemmed Prophylactic open abdomen in patients with postoperative intra-abdominal hypertension
title_short Prophylactic open abdomen in patients with postoperative intra-abdominal hypertension
title_sort prophylactic open abdomen in patients with postoperative intra-abdominal hypertension
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2875490/
https://www.ncbi.nlm.nih.gov/pubmed/20156323
http://dx.doi.org/10.1186/cc8207
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