Sublingual microcirculatory changes during transient intra-abdominal hypertension – A prospective observational study in laparoscopic surgery patients

2014 ◽  
Vol 57 (4) ◽  
pp. 367-374 ◽  
Author(s):  
Liivi Maddison ◽  
Kairi Marie Riigor ◽  
Juri Karjagin ◽  
Joel Starkopf
Keyword(s):  
Laparoscopic Surgery ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Abdominal Hypertension

scholarly journals The effect of reference position versus right lateral position on the intra-abdominal pressure in mechanically ventilated patients

2018 ◽  
Vol 8 (6) ◽  
pp. 93
Author(s):  
Ghada Shalaby Khalaf Mahran ◽  
Sayed K. Abd-Elshafy ◽  
Manal Mohammed Abd El Neem ◽  
Jehan A. Sayed
Keyword(s):  
Mechanical Ventilation ◽  
Critical Care ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Body Position ◽  
Critical Issue ◽  
Lateral Position ◽  
Abdominal Pressure ◽  
University Hospitals ◽  
Abdominal Hypertension

Background and objective: Intra-abdominal hypertension (IAH) is a frequent plentiful problem in patients admitted to critical care units. It ranges from a surge incidence of morbidity and mortality to a particular need for nursing health care, so recognition of the occurrence of IAH is a very critical issue for critical care nurses and physician. This study aimed to recognize the effects of various body position with the various head of bed elevation on the intra-abdominal pressure (IAP) in patients with mechanical ventilation.Methods: Design: A non-randomized, prospective observational study was used. Setting: Trauma and general intensive care units at Assuit University Hospitals. Method: In a prospective observational study, during the third day of mechanical ventilation, 60 patients were screened for IAP via a urinary catheter, in two various body positions in three separate degrees of the head of the bed (HOB) elevation (0º, 15º, and 30º). The position was changed at least 4 hours apart over a 24-h period.Results: In lateral recumbence, IAP measurements were significantly elevated compared to supine position, they were 19.70 ± 3.09 mmHg versus 16.00 ± 3.14 (p < .001), 22.80 ± 3.56 mmHg versus 19.03 ± 2.95 (p < .001), and 26.08 ± 3.59 mmHg versus 21.46 ± 2.90 versus (p < .001) at 0º, 15º, and 30º respectively. The mean of IAP difference was 3.7 ± 3.0 mmHg at 0º, 3.8 ± 1.00 mmHg at 15º, and 5.5 ± 1.01 mmHg at 30 º (p < .005).Conclusions: IAP reading is significantly elevated by changing from supine to lateral position especially with HOB elevation and significantly correlated with mortality rate in patients with mechanical ventilation

scholarly journals Predictors of catheter-related bladder discomfort after gynaecological surgery

2019 ◽  
Author(s):  
Shuying Li ◽  
Liping Song ◽  
Yushan Ma ◽  
Xuemei Lin
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Pain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Urinary Catheterization ◽  
Gynaecological Surgery ◽  
High Age ◽  
Very High

Abstract Background: Urinary catheterization is universally used during surgery, and the incidence of postoperative catheter-related bladder discomfort (CRBD) is very high during recovery. We conducted this study to identify the incidence and predictors of postoperative CRBD after gynaecological surgery in the post-anesthesia care unit (PACU). Methods: This was a prospective observational study. Patients undergoing gynaecological surgery under general anesthesia with intra-operative urinary catheterization were enrolled. We collected the clinical data, incidence and severity of CRBD, and postoperative pain for the patients. Predictive factors of CRBD were analysed by univariate and multivariate analysis. Results: A total of 407 patients were included in this study. The incidence of CRBD after gynaecological surgery was 64.6% (mild CRBD: 22.8%; moderate CRBD: 34.2%; and severe CRBD: 7.6%). Univariate analysis showed that age, type of surgery, type of laparoscopic surgery, additional analgesics, and postoperative pain were influencing factors for CRBD. Based on multivariate logistic regression analysis, age ≥50 years, uterus-related laparoscopic surgery, and lack of additional analgesics were independent predictors of moderate or severe CRBD. Conclusions: This observational study revealed that the incidence of CRBD after gynaecological surgery in PACU was very high. Age ≥50 years, uterus-related laparoscopic surgery, and lack of additional analgesics were independent predictors of CRBD.

scholarly journals Predictors of catheter-related bladder discomfort after gynaecological surgery

2019 ◽  
Author(s):  
Shuying Li ◽  
Liping Song ◽  
Yushan Ma ◽  
Xuemei Lin
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Pain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Urinary Catheterization ◽  
Gynaecological Surgery ◽  
Very High ◽  
Drug Prophylaxis

Abstract Background: Urinary catheterization is universally used during surgery, and the incidence of postoperative catheter-related bladder discomfort (CRBD) is very high during recovery. We conducted this study to identify the incidence and predictors of postoperative CRBD after gynaecological surgery in the post-anesthesia care unit (PACU). Methods: This was a prospective observational study. Patients undergoing gynaecological surgery under general anesthesia with intra-operative urinary catheterization were enrolled. We collected the clinical data, incidence and severity of CRBD, and postoperative pain for the patients. Predictive factors of CRBD were analysed by univariate and multivariate analysis. Results: A total of 407 patients were included in this study. The incidence of CRBD after gynaecological surgery was 64.6% (mild CRBD: 22.8%; moderate CRBD: 34.2%; and severe CRBD: 7.6%). Univariate analysis showed that age, type of surgery, type of laparoscopic surgery, additional analgesics, and postoperative pain were influencing factors for CRBD. Based on multivariate logistic regression analysis, age ≥50 years, uterus-related laparoscopic surgery, and lack of additional analgesics were independent predictors of moderate or severe CRBD. Conclusions: This observational study revealed that the incidence of CRBD after gynaecological surgery in PACU was very high and it was a very distressing experience for patients. We suggested that drug prophylaxis should be used to the patients with high risk of CRBD in gynaecological surgery.

scholarly journals Predictors of catheter-related bladder discomfort after gynaecological surgery

2019 ◽  
Author(s):  
Shuying Li ◽  
Liping Song ◽  
Yushan Ma ◽  
Xuemei Lin
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Pain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Urinary Catheterization ◽  
Gynaecological Surgery ◽  
Very High ◽  
Drug Prophylaxis

Abstract Background: Urinary catheterization is universally used during surgery, and the incidence of postoperative catheter-related bladder discomfort (CRBD) is very high during recovery. We conducted this study to identify the incidence and predictors of postoperative CRBD after gynaecological surgery in the post-anesthesia care unit (PACU). Methods: This was a prospective observational study. Patients undergoing gynaecological surgery under general anesthesia with intra-operative urinary catheterization were enrolled. We collected the clinical data, incidence and severity of CRBD, and postoperative pain for the patients. Predictive factors of CRBD were analysed by univariate and multivariate analysis. Results: A total of 407 patients were included in this study. The incidence of CRBD after gynaecological surgery was 64.6% (mild CRBD: 22.8%; moderate CRBD: 34.2%; and severe CRBD: 7.6%). Univariate analysis showed that age, type of surgery, type of laparoscopic surgery, additional analgesics, and postoperative pain were influencing factors for CRBD. Based on multivariate logistic regression analysis, age ≥50 years, uterus-related laparoscopic surgery, and lack of additional analgesics were independent predictors of moderate or severe CRBD. Conclusions: This observational study revealed that the incidence of CRBD after gynaecological surgery in PACU was very high and it was a very distressing experience for patients. We suggested that drug prophylaxis should be used to the patients with high risk of CRBD in gynaecological surgery.

scholarly journals Prevalence of intra-abdominal hypertension and markers for associated complications among severe burn patients: a multicenter prospective cohort study (BURNIAH study)

2021 ◽  
Author(s):  
Steven G. Strang ◽  
Roelf S. Breederveld ◽  
Berry I. Cleffken ◽  
Michael H. J. Verhofstad ◽  
Oscar J. F. Van Waes ◽  
...  
Keyword(s):  
Fatty Acid ◽  
Observational Study ◽  
Organ Failure ◽  
Fatty Acid Binding Protein ◽  
Prospective Observational Study ◽  
Burn Patients ◽  
Severe Burn ◽  
Fatty Acid Binding ◽  
Acid Binding Protein ◽  
Abdominal Hypertension

Abstract Purpose Severely burned patients are at risk for intra-abdominal hypertension (IAH) and associated complications such as organ failure, abdominal compartment syndrome (ACS), and death. The aim of this study was to determine the prevalence of IAH among severely burned patients. The secondary aim was to determine the value of urinary intestinal fatty acid binding protein (I-FABP) as early marker for IAH-associated complications. Methods A prospective observational study was performed in two burn centers in the Netherlands. Fifty-eight patients with burn injuries ≥ 15% of total body surface area (TBSA) were included. Intra-abdominal pressure (IAP) and urinary I-FABP, measured every 6 h during 72 h. Prevalence of IAH, new organ failure and ACS, and the value of urinary intestinal fatty acid binding protein (I-FABP) as early marker for IAH-associated complications were determined. Results Thirty-one (53%) patients developed IAH, 17 (29%) patients developed new organ failure, but no patients developed ACS. Patients had burns of 29% (P25–P75 19–42%) TBSA. Ln-transformed levels of urinary I-FABP and IAP were inversely correlated with an estimate of − 0.06 (95% CI − 0.10 to − 0.02; p = 0.002). Maximal urinary I-FABP levels had a fair discriminatory ability for patients with IAH with an area under the ROC curve of 74% (p = 0.001). Urinary I-FABP levels had no predictive value for IAH or new organ failure in severe burn patients. Conclusions The prevalence of IAH among patients with ≥ 15% TBSA burned was 53%. None of the patients developed ACS. A relevant diagnostic or predictive value of I-FABP levels in identifying patients at risk for IAH-related complications, could not be demonstrated. Level of evidence Level III, epidemiologic and diagnostic prospective observational study.

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