Ohad Guetta1, Evgeni Brotfain2, Gad Shaked3, Gilbert Sebbag4, Moti Klein5, David Czeiger4. 1. Department General Surgery B, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, Be'er Sheva, Israel. ohadguetta@gmail.com. 2. Department of Anesthesiology and Critical Care, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel. 3. Head of Trauma Unit, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel. 4. Department General Surgery B, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, Be'er Sheva, Israel. 5. Head of Critical Care Department, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
Abstract
PURPOSE: To estimate the change in intra-abdominal pressure (IAP) among critically ill patient who were left with open abdomen and temporary abdominal closure after laparotomy, during the first 48 h after admission. METHODS: A cohort study in a single ICU in a tertiary care hospital. All adult patients admitted to the ICU after emergent laparotomy for acute abdomen or trauma, who were left with temporary abdominal closure (TAC), were included. Patients were followed up to 48 h. IAP was routinely measured at 0, 6, 12, 24, and 48 h after admission to ICU. RESULTS: Thirty-nine patients were included, 34 were operated due to acute abdomen and 5 due to abdominal trauma. Seventeen patients were treated with skin closure, 13 with Bogota bag, and 9 with negative pressure wound therapy (NPWT). Eleven patients (28.2%) had IAP of 15 mmHg or above at time 0, (mean pressure 19.0 ± 3.0 mmHg), and it dropped to 12 ± 4 mmHg within 48 h (p < 0.01). Reduction in lactate level (2.4 ± 1.0 to 1.2 ± 0.2 mmol/L, p < 0.01) and increase in PaO2/FiO2 ratio (163 ± 34 to 231 ± 83, p = 0.03) were observed as well after 48 h. CONCLUSIONS: This is the first large report of IAP in open abdomen. Elevated IAP may be measured in open abdomen and may subsequently relieve after 48 h.
PURPOSE: To estimate the change in intra-abdominal pressure (IAP) among critically ill patient who were left with open abdomen and temporary abdominal closure after laparotomy, during the first 48 h after admission. METHODS: A cohort study in a single ICU in a tertiary care hospital. All adult patients admitted to the ICU after emergent laparotomy for acute abdomen or trauma, who were left with temporary abdominal closure (TAC), were included. Patients were followed up to 48 h. IAP was routinely measured at 0, 6, 12, 24, and 48 h after admission to ICU. RESULTS: Thirty-nine patients were included, 34 were operated due to acute abdomen and 5 due to abdominal trauma. Seventeen patients were treated with skin closure, 13 with Bogota bag, and 9 with negative pressure wound therapy (NPWT). Eleven patients (28.2%) had IAP of 15 mmHg or above at time 0, (mean pressure 19.0 ± 3.0 mmHg), and it dropped to 12 ± 4 mmHg within 48 h (p < 0.01). Reduction in lactate level (2.4 ± 1.0 to 1.2 ± 0.2 mmol/L, p < 0.01) and increase in PaO2/FiO2 ratio (163 ± 34 to 231 ± 83, p = 0.03) were observed as well after 48 h. CONCLUSIONS: This is the first large report of IAP in open abdomen. Elevated IAP may be measured in open abdomen and may subsequently relieve after 48 h.
Authors: Osvaldo Chiara; Stefania Cimbanassi; Walter Biffl; Ari Leppaniemi; Sharon Henry; Thomas M Scalea; Fausto Catena; Luca Ansaloni; Arturo Chieregato; Elvio de Blasio; Giorgio Gambale; Giovanni Gordini; Guiseppe Nardi; Pietro Paldalino; Francesco Gossetti; Paolo Dionigi; Giuseppe Noschese; Gregorio Tugnoli; Sergio Ribaldi; Sebastian Sgardello; Stefano Magnone; Stefano Rausei; Anna Mariani; Francesca Mengoli; Salomone di Saverio; Maurizio Castriconi; Federico Coccolini; Joseph Negreanu; Salvatore Razzi; Carlo Coniglio; Francesco Morelli; Maurizio Buonanno; Monica Lippi; Liliana Trotta; Annalisa Volpi; Luca Fattori; Mauro Zago; Paolo de Rai; Fabrizio Sammartano; Roberto Manfredi; Emiliano Cingolani Journal: J Trauma Acute Care Surg Date: 2016-01 Impact factor: 3.313
Authors: Manu L N G Malbrain; Davide Chiumello; Paolo Pelosi; David Bihari; Richard Innes; V Marco Ranieri; Monica Del Turco; Alexander Wilmer; Nicola Brienza; Vincenzo Malcangi; Jonathan Cohen; Andre Japiassu; Bart L De Keulenaer; Ronny Daelemans; Luc Jacquet; Pierre-François Laterre; Günther Frank; Paulo de Souza; Bruno Cesana; Luciano Gattinoni Journal: Crit Care Med Date: 2005-02 Impact factor: 7.598
Authors: Derek J Roberts; David A Zygun; Jan Grendar; Chad G Ball; Helen Lee Robertson; Jean-Francois Ouellet; Michael L Cheatham; Andrew W Kirkpatrick Journal: J Trauma Acute Care Surg Date: 2012-09 Impact factor: 3.313
Authors: Andrew W Kirkpatrick; Derek J Roberts; Jan De Waele; Roman Jaeschke; Manu L N G Malbrain; Bart De Keulenaer; Juan Duchesne; Martin Bjorck; Ari Leppaniemi; Janeth C Ejike; Michael Sugrue; Michael Cheatham; Rao Ivatury; Chad G Ball; Annika Reintam Blaser; Adrian Regli; Zsolt J Balogh; Scott D'Amours; Dieter Debergh; Mark Kaplan; Edward Kimball; Claudia Olvera Journal: Intensive Care Med Date: 2013-05-15 Impact factor: 17.440
Authors: Fernando Rodríguez-Holguín; Adolfo González Hadad; David Mejia; Alberto García; Cecibel Cevallos; Amber Nicole Himmler; Yaset Caicedo; Alexander Salcedo; José Julián Serna; Mario Alain Herrera; Luis Fernando Pino; Michael W Parra; Carlos A Ordoñez Journal: Colomb Med (Cali) Date: 2021-06-30