Perioperative intra-abdominal pressure monitoring in emergency laparotomy
DOI:
https://doi.org/10.18203/2349-2902.isj20171014Keywords:
Abdominal compartment syndrome, Intra-abdominal pressure, LaparotomyAbstract
Background: The aim of present study is to evaluate the perioperative monitoring of intra-abdominal pressure and abdominal compartment syndrome and its association with the postoperative morbidity in terms of kidney function and pulmonary atelectasis and mortality of the patients undergoing emergency laparotomy.
Methods: A prospective study was done in 100 patients undergoing laparotomy. The study was conducted in the department of general surgery, Government Kilpauk medical college and hospital for the period of six months from January 2015 to June 2015. The study group of 100 patients was divided into 2 groups, each group containing 50 patients. The first group containing 50 patients having increased intra-abdominal pressure undergoing emergency laparotomy and second group containing 50 patients undergoing elective laparotomy. The post-operative morbidity in terms of kidney function by means of urea, creatinine and urine output and pulmonary atelectasis with the help of chest x-ray and mortality analyzed compared in between the two groups.
Results: By comparing the two groups, the group undergoing emergency laparotomy with increased intra-abdominal pressure had increase in the incidence of postoperative morbidity and mortality than the elective laparotomy group without elevated intra-abdominal pressure.
Conclusions: Thus, the perioperative monitoring of intra-abdominal pressure is highly useful in diagnosing intra-abdominal hypertension and abdominal compartment syndrome and thereby helps in minimizing the post-operative morbidity and mortality in emergency laparotomy patients.
References
Cheatham ML. Abdominal compartment syndrome; pathophysiology and definitions. Scand J Trauma Resusc Emerg Med. 2009;17:10.
Malbrain ML1, Cheatham ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, et al. Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. Definitions. Intensive Care Med. 2006;32(11):1722-32.
Fietsam R Jr, Villalba M, Glover JL, Clark K. Intra-abdominal syndrome as a complication of ruptured abdominal aortic aneurysm repair. Am Surg. 1989;55(6):396-402.
Papavramidis TS, Marinis AD, Pliakos I, Kesisoglou I, Papavramidou N. Abdominal compartment syndrome - Intra-abdominal hypertension: Defining, diagnosing, and managing. J Emerg Trauma Shock. 2011;4(2):279-91.
Cheatham ML, White MW, Sagraves SG, Johnson JL, Block EF. Abdominal perfusion pressure: A superior parameter in the assessment of intra-abdominal hypertension. J Trauma. 2000;49(4):621-6.
Sugrue M. Abdominal compartment syndrome. Curr Opin Crit Care. 2005;11(4):333-8.
Sugrue M1, Bauman A, Jones F, Bishop G, Flabouris A, Parr M, et al. Clinical examination is an inaccurate predictor of intra-abdominal pressure. World J Surg. 2002;26(12):1428-31.
Shear W, Rosner MH. Acute kidney dysfunction due to the abdominal compartment syndrome. J Nephrol. 2006;19(5):556-65.
