Document Detail


The relative merits of various methods of indirect measurement of intraabdominal pressure as a guide to closure of abdominal wall defects.
MedLine Citation:
PMID:  2964519     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Visceral ischemia secondary to increased intraabdominal pressure (IAP) following closure of abdominal wall defects presents a serious postoperative problem. Currently, the method of closure and postoperative management are determined by clinical impressions rather than measurement of IAP. In this study various methods of indirectly measuring IAP were compared in 17 rabbits in which IAP was sequentially increased with an intraabdominal balloon. Vesical and inferior vena caval (IVC) pressures were found to have good statistical correlation with IAP. Other methods tested were gastric, rectal, superior vena caval, femoral and brachial artery, and rectus compartment pressures. All were found to be poor indicators of actual IAP. In nine of the rabbits, radiolabeled microspheres were used to assess cardiac output and visceral blood flow. Renal blood flow was very sensitive to increased IAP with dramatic impairment at IAP above 10 to 15 mmHg. Small intestinal flow was less sensitive and did not become significantly diminished until IAP exceeded 25 to 30 mmHg. Our studies suggest that vesical and IVC pressure monitoring should be used to evaluate IAP in the clinical setting. If IAP is in excess of 10 to 15 mmHg surgical intervention is indicated to prevent the development of renal ischemia.
Authors:
S R Lacey; J Bruce; S P Brooks; J Griswald; W Ferguson; J E Allen; T C Jewett; M P Karp; D R Cooney
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  22     ISSN:  0022-3468     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  1987 Dec 
Date Detail:
Created Date:  1988-04-11     Completed Date:  1988-04-11     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1207-11     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Buffalo, State University of New York, NY.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Muscles / abnormalities*,  blood supply,  surgery
Animals
Blood Flow Velocity*
Disease Models, Animal
Pressure / diagnostic use*
Rabbits
Viscera / blood supply

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


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