OBJECTIVE: The objective was to prospectively study the effect of neuromuscular blockers on intra-abdominal pressure (IAP) and a number of physiological variables in patients with increased IAP. DESIGN: Prospective cohort study. SETTING: Intensive care unit of the Ghent University Hospital. PATIENTS AND PARTICIPANTS: Ten critically ill patients with intra-abdominal hypertension (IAH). INTERVENTIONS: An intravenous bolus of cisatracurium at a dose of 0.15 mg/kg was administered, and IAP was measured just before administration and then at 15, 30, 60 and 120 min. The effect of cisatracurium on central venous pressure (CVP), mean arterial pressure (MAP), abdominal perfusion pressure (APP) and heart rate (HR) was also evaluated. Urinary output was recorded prior to administration and after 60 and 120 min. MEASUREMENTS AND RESULTS: The median age of the patients was 50 years (interquartile range 38-65); five of them were male. APACHE II score on admission was 29 (IQR 14-37). IAH was caused by massive fluid resuscitation without obvious abdominal problem in five patients, by abdominal trauma in three, and by burns and bowel distension in one patient each. Bolus administration of cisatracurium significantly decreased IAP from 18 mmHg (16-20) at baseline to 14 mmHg (12-16) at 15 min (p = 0.01) and to 14 mmHg (13-17) at 30 min (p = 0.02). MAP, APP, CVP and HR remained unchanged. No significant effect on urinary output was observed. In all patients, IAP returned to the baseline level after 2 h. CONCLUSIONS: Bolus administration of cisatracurium can be used to temporarily reduce IAP in patients with IAH.
OBJECTIVE: The objective was to prospectively study the effect of neuromuscular blockers on intra-abdominal pressure (IAP) and a number of physiological variables in patients with increased IAP. DESIGN: Prospective cohort study. SETTING: Intensive care unit of the Ghent University Hospital. PATIENTS AND PARTICIPANTS: Ten critically ill patients with intra-abdominal hypertension (IAH). INTERVENTIONS: An intravenous bolus of cisatracurium at a dose of 0.15 mg/kg was administered, and IAP was measured just before administration and then at 15, 30, 60 and 120 min. The effect of cisatracurium on central venous pressure (CVP), mean arterial pressure (MAP), abdominal perfusion pressure (APP) and heart rate (HR) was also evaluated. Urinary output was recorded prior to administration and after 60 and 120 min. MEASUREMENTS AND RESULTS: The median age of the patients was 50 years (interquartile range 38-65); five of them were male. APACHE II score on admission was 29 (IQR 14-37). IAH was caused by massive fluid resuscitation without obvious abdominal problem in five patients, by abdominal trauma in three, and by burns and bowel distension in one patient each. Bolus administration of cisatracurium significantly decreased IAP from 18 mmHg (16-20) at baseline to 14 mmHg (12-16) at 15 min (p = 0.01) and to 14 mmHg (13-17) at 30 min (p = 0.02). MAP, APP, CVP and HR remained unchanged. No significant effect on urinary output was observed. In all patients, IAP returned to the baseline level after 2 h. CONCLUSIONS: Bolus administration of cisatracurium can be used to temporarily reduce IAP in patients with IAH.
Authors: Manu L N G Malbrain; Michael L Cheatham; Andrew Kirkpatrick; Michael Sugrue; Michael Parr; Jan De Waele; Zsolt Balogh; Ari Leppäniemi; Claudia Olvera; Rao Ivatury; Scott D'Amours; Julia Wendon; Ken Hillman; Kenth Johansson; Karel Kolkman; Alexander Wilmer Journal: Intensive Care Med Date: 2006-09-12 Impact factor: 17.440
Authors: Manu L N G Malbrain; Davide Chiumello; Paolo Pelosi; Alexander Wilmer; Nicola Brienza; Vincenzo Malcangi; David Bihari; Richard Innes; Jonathan Cohen; Pierre Singer; Andre Japiassu; Elizabeth Kurtop; Bart L De Keulenaer; Ronny Daelemans; Monica Del Turco; P Cosimini; Marco Ranieri; Luc Jacquet; Pierre-François Laterre; Luciano Gattinoni Journal: Intensive Care Med Date: 2004-02-03 Impact factor: 17.440
Authors: Massimo Antonelli; Elie Azoulay; Marc Bonten; Jean Chastre; Giuseppe Citerio; Giorgio Conti; Daniel De Backer; François Lemaire; Herwig Gerlach; Johan Groeneveld; Goran Hedenstierna; Duncan Macrae; Jordi Mancebo; Salvatore M Maggiore; Alexandre Mebazaa; Philipp Metnitz; Jerôme Pugin; Jan Wernerman; Haibo Zhang Journal: Intensive Care Med Date: 2008-02-29 Impact factor: 17.440
Authors: Inneke E De Laet; Mariska Ravyts; Wesley Vidts; Jody Valk; Jan J De Waele; Manu L N G Malbrain Journal: Langenbecks Arch Surg Date: 2008-06-17 Impact factor: 3.445
Authors: Stephan M Jakob; Rafael Knuesel; Jyrki J Tenhunen; Richard Pradl; Jukka Takala Journal: BMC Gastroenterol Date: 2010-07-04 Impact factor: 3.067