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Titolo:
Multisystem organ failure secondary to increased intraabdominal pressure
Autore:
Sugerman, HJ; Bloomfield, GL; Saggi, BW;
Indirizzi:
Virginiaiv,mmonwealth Univ, Med Coll Virginia, Dept Surg, Gen Surg Trauma D Virginia Commonwealth Univ Richmond VA USA 23298 Surg, Gen Surg Trauma D
Titolo Testata:
INFECTION
fascicolo: 1, volume: 27, anno: 1999,
pagine: 57 - 62
SICI:
0300-8126(199901/02)27:1<57:MOFSTI>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTRA-ABDOMINAL PRESSURE; PLANNED MULTIPLE LAPAROTOMIES; BLOOD-FLOW; INTRACRANIAL-PRESSURE; COMPARTMENT SYNDROME; VOLUME EXPANSION; RENAL-FUNCTION; WALL DEFECTS; CLOSURE; CELIOTOMY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Sugerman, HJ Virginiaiv,mmonwealth Univ, Med Coll Virginia, Dept Surg, GenSurg Trauma D Virginia Commonwealth Univ POB 980519,MCV Stn Richmond VA USA 23298
Citazione:
H.J. Sugerman et al., "Multisystem organ failure secondary to increased intraabdominal pressure", INFECTION, 27(1), 1999, pp. 57-62

Abstract

Acutely increased intraabdominal pressure can lead to multisystem organ dysfunction. Organ dysfunction consists of acute pulmonary failure secondary to compressive atelectasis and associated with high peak inspiratory pressures and impaired gas exchange, acute renal failure with marked oliguria without hypernaturia, intestinal and hepatic ischemia possibly leading to bacterial translocation or necrosis with peritonitis, increased intracranial pressures which may cause brain dysfunction or aggravate head injury edema, venous thrombosis and thromboembolism, and abdominal wall ischemia or necrosis. The diagnosis is made clinically in a patient,vith high peak inspiratory pressures, oliguria and an apparently tight abdomen, although urinary bladder pressure greater than or equal to 20 cm H2O pressure is suggestive. However, chronically increased intraabdominal pressure as is seen in the morbidly obese, pregnancy and cirrhosis may be misleading. As to treatment, once the diagnosis is made, the patient's abdomen should be opened and the tension relieved. The intestinal contents need to be protected and evaporativewater loss minimized by either closing the skin and not the fascia or, if this is not possible, using an impermeable protective dressing. If the abdomen is difficult to close at the primary operation, it is best to prevent the development of an acute abdominal compartment syndrome by closing only the skin or leaving it open and using an impermeable dressing. In conclusion, the acute abdominal compartment syndrome has become increasingly recognized as a cause for multisystem organ failure. Recognition of the problem or prevention is mandatory for optimal patient survival.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 24/10/20 alle ore 12:04:13