Document Detail


Endoscopic components separation for abdominal compartment syndrome.
MedLine Citation:
PMID:  12885610     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Sustained intraabdominal pressures of 14 to 20 mm Hg have significant pathophysiological consequences, but there is currently no satisfactory low-morbidity procedure appropriate for intervention early in the disease process of abdominal compartment syndrome (ACS). The anatomical principles of abdominal wall components separation were used to develop a percutaneous procedure that increased abdominal capacity and decreased abdominal pressure. METHODS: Using a porcine model, we determined abdominal capacity changes by helium insufflation. Corn oil was then used to create an episode of sustained intraabdominal hypertension and changes in intraabdominal pressure and intestinal mucosal oxygenation were determined. RESULTS: Endoscopic abdominal wall components separation (EACS) increased abdominal capacity by 1 L (from 0.89 +/- 0.39 L to 1.95 +/- 0.48 L; P <0.001). During intraabdominal hypertension, EACS decreased abdominal pressure by 31.6% (from 15.9 +/- 2.1 to 11.0 +/- 1.5 mm Hg; P <0.001). Intestinal PO(2) was increased by 61% (18.8 +/- 11.4 to 30.3 +/- 11.7; P = 0.012) CONCLUSIONS: A minimally invasive procedure (EACS) is feasible and has demonstrated effectiveness in a porcine model of ACS.
Authors:
Miranda Voss; Jose Pinheiro; James Reynolds; Rebecca Greene; Mark Dewhirst; Steven N Vaslef; Erik Clary; W Steve Eubanks
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of surgery     Volume:  186     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-07-29     Completed Date:  2003-08-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  158-63     Citation Subset:  AIM; IM    
Affiliation:
Division of Surgery, Box 3479, Duke University Medical Center, Durham, NC 27707, USA. mvoss@duke.edu
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MeSH Terms
Descriptor/Qualifier:
Abdominal Wall
Animals
Compartment Syndromes / physiopathology,  surgery*
Endoscopy*
Insufflation
Intestinal Mucosa / metabolism
Oxygen / metabolism
Pressure
Swine
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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