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Intensive Care Medicine

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01.10.2006 | Technical Note

Measurement of compartment pressure of the rectus sheath during intra-abdominal hypertension in rats

verfasst von: Christoph Meier, René Schramm, Joerg H. Holstein, Burkhardt Seifert, Otmar Trentz, Michael D. Menger

Erschienen in: Intensive Care Medicine | Ausgabe 10/2006

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Abstract

Objective

To investigate whether the compartment pressure of the rectus sheath (CPRS) reflects the intra-abdominal pressure (IAP) under various conditions of intra-abdominal hypertension (IAH).

Design and setting

Prospective experimental study with in vivo pressure measurements at the Institute for Clinical and Experimental Surgery, University of Saarland.

Animals

Sprague-Dawley rats.

Interventions

Stepwise increase and decrease in IAP with continuous measurement of the correspondent CPRS.

Measurements and results

Physiological IAP (2 mmHg) and CPRS (6 mmHg) showed a statistically significant difference. Stepwise elevation in IAP was associated with a simultaneous increase in CPRS. Accordingly, stepwise decompression of IAP resulted in a stepwise decrease in CPRS. Under both conditions Bland-Altman analysis comparing IAP to correspondent CPRS showed a very good agreement for IAP at or above 12 mmHg. In addition, closure of the overlaying subcutaneous tissue and skin did not affect CPRS or its correlation with IAP.

Conclusions

CPRS accurately reflects IAP for IAP of 12 mmHg or higher. Thus CPRS measurements may represent a novel approach for diagnosis and monitoring of IAH.

Nur mit Berechtigung zugänglich

Rotondo MF, Schwab CW, McGonigal MD, Phillips GR 3rd, Fruchterman TM, Kauder DR, Latenser BA, Angood PA (1993) “Damage control”: an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma 35:375–382PubMed

Raeburn CD, Moore EE, Biffl WL, Johnson JL, Meldrum DR, Offner PJ, Francoise RJ, Burch JM (2001) The abdominal compartment syndrome is a morbid complication of postinjury damage control surgery. Am J Surg 182:542–546PubMedCrossRef

Diebel LN, Dulchavsky SA, Brown WJ (1997) Splanchnic ischaemia and bacterial translocation in the abdominal compartment syndrome. J Trauma 43:852–855PubMed

Balogh Z, McKinley BA, Holcomb JB, Miller CC, Cocanour CS, Kozar RA, Valdivia A, Ware DN, Moore FA (2003) Both primary and secondary abdominal compartment syndrome can be predicted early and are harbringers of multiple organ failure. J Trauma 54:848–859PubMed

Sugrue M, Jones F, Lee A, Buist MD, Deane S, Bauman A, Hillman K (1996) Intraabdominal pressure and gastric intramucosal pH: Is there an association? World J Surg 20:988–991PubMedCrossRef

Malbrain ML, Chiumello D, Pelosi P, Wilmer A, Brienza N, Malcangi V, Bihari D, Innes R, Cohen J, Singer P, Japiassu A, Kurtop E, De Keulenaer BL, Del Turco M, Cosimini P, Ranieri M, Jacquet L, Laterre PF, Gattinoni L (2004) Prevalence of intra-abdominal hypertension in critically ill patients: a multicentre epidemiological study. Intensive Care Med 30:822–829PubMedCrossRef

Malbrain ML, Chiumello D, Pelosi P, Bihari D, Innes R, Ranieri M, Del Turco M, Wilmer A, Brienza N, Malcangi V, Cohen J, Japiassu A, De Keulenaer BL, Daelemans R, Jacquet L, Laterre PF, Gunther F, de Souza P, Cesana B, Gattinoni L (2005) Incidence and prognosis of intraabdominal hypertension in a mixed population of critically ill patients: a multiple-center epidemiological study. Crit Care Med 33:315–322PubMedCrossRef

Malbrain MLNG (2004) Different techniques to measure intra-abdominal pressure (IAP): time for a critical re-appraisal. Intensive Care Med 30:357–371PubMedCrossRef

Sugrue M (2002) Intra-abdominal pressure: time for clinical practice guidelines? Intensive Care Med 28:389–391PubMedCrossRef

10.

Schachtrupp A, Tons C, Fackeldey V, Hoer J, Reinges M, Schumpelick V (2003) Evaluation of two novel methods for the direct and continuous measurement of the intra-abdominal pressure in a porcine model. Intensive Care Med 29:1605–1608PubMedCrossRef

11.

Balogh Z, Felicity Jones, D'Amours S, Parr M, Sugrue M (2004) Continuous intra-abdominal pressure measurement technique. Am J Surg 188:679–684PubMedCrossRef

12.

Deeren DH, Dits H, Malbrain MLNG (2005) Correlation between intra-abdominal and intracranial pressure in nontraumatic brain injury. Intensive Care Med 31:1577–1581PubMedCrossRef

13.

Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurements. Lancet I:307–310

14.

Bland JM, Altman DG (1995) Comparing methods of measurement: why plotting difference against standard method is misleading. Lancet 346:1085–1087PubMedCrossRef

15.

Diebel L, Saxe J, Dulchavsky S (1992) Effect of intra-abdominal pressure on abdominal wall blood flow. Am Surg 58:773–775

16.

De Potter TJ, Dits H, Malbrain ML (2005) Intra- and interobserver variability during in vitro validation of two novel methods for intra-abdominal pressure. Intensive Care Med 31:747–751PubMedCrossRef

17.

Cheatham ML, Safcsak K (1998) Intraabdominal pressure: a revised method for measurement. J Am Coll Surg 186:594–595PubMedCrossRef

18.

Iberti TJ, Kelly KM, Gentil DR, Hirsch S, Benjamin E (1987) A simple technique to accurately determine intraabdominal pressure. Crit Care Med 15:1140–1142PubMedCrossRef

19.

Sugrue M (1995) Intra-abdominal pressure. Clin Intensive Care 6:76–79

20.

Fusco MA, Shayn MR, Chang MC (2001) Estimation of intra-abdominal pressure by bladder pressure measurement: validity and methodology. J Trauma 50:297–302PubMedCrossRef

21.

Gudmundsson FF, Viste A, Gislason H, Svanes K (2002) Comparison of different methods for measuring intra-abdominal pressure. Intensive Care Med 28:509–514PubMedCrossRef

Titel: Measurement of compartment pressure of the rectus sheath during intra-abdominal hypertension in rats
verfasst von: Christoph Meier
René Schramm
Joerg H. Holstein
Burkhardt Seifert
Otmar Trentz
Michael D. Menger
Publikationsdatum: 01.10.2006
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 10/2006
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-006-0366-4

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Measurement of compartment pressure of the rectus sheath during intra-abdominal hypertension in rats