Intra-Abdominal Pressure Monitoring By Nurses For Early Detection Of Abdominal Compartment Syndrome And Early Decompressed Laparotomy In Comparison With Need To Laparotomy By Physical Exam

Intra-Abdominal Pressure Monitoring For Early Detection Of Abdominal Compartment Syndrome

  • Rahim Ali Sheikhi
  • Mohammad Heidari
Keywords: Intra-Abdominal Hypertension; Abdominal Compartment Syndrome; Physical Examination

Abstract

Background& Objective:Abdominal compartment syndrome is as potentially lethal condition caused by any
event that produces intra-abdominal hypertension. The most common cause is blunt abdominal trauma. Increasing
intra-abdominal pressure affects much vital body system. Hemodynamic, respiratory, renal and neurological
abnormalities are hallmark of ACS. All authors are agreeing that decompression laparotomy is the treatment of
choice for the ACS. Nursing care involves vigilant monitoring for early detection including serial measurement of
intra-abdominal pressure (from urinary bladder). This study was designed to investigate the comparative effect of
measurement of intra-abdominal pressure and physical exam in patient with ACS for refer the patients to operation
room. Methodology:In this research ACS was defined as abdominal distention with intra-abdominal pressure ≥15 mm
Hg (20cm H2O) accompanied by at least two of the following: oliguria or anuria, hypoxemia and hypotension or
shock. When ACS detected by researcher, compared with diagnose of need to laparotomy by physician both timely
and numerically.Results:Of 100 patients admitted over 8 months, 28 patients had abdominal compartment
syndrome, 21 of this patients refer to operation room by physician. According to numeral comparison between two
group not significant (P>.05) but according the time measuring abdominal pressure for detection of need to
decompressed laparotomy significantly decreased than physical exam (p<.05).Conclusion:The ACS is a potentially
lethal condition occurs in a significant number of severely blunt abdominal trauma patients and it develops quickly.
Preventative therapy should be instituted to minimize its development in patients at risk and monitoring of intraabdominal
pressure may allow prompt treatment of this condition rather than physical exam.[Heidari MNJIRM 2016;
7(2):18-23]

References

1. Spencer P, Kinsman L, Fuzzard K. A critical care nurse’s
guide to intra-abdominalhypertension and abdominal
compartment syndrome. Australian Critical Care.
2008; 21: 18-2816.
2. Malbrain M, Chiumello D, Pelosi P, Bihari D, Innes
R, Raniei V, et al. Incidence and prognosis of intraabdominal
hypertension in a mixed population of
critically ill patients: a multiple-center
epidemiological study. Critical Care Med. 2005;
33(2): 315-22.
3. Biffl W, Moore E, Burch J, Reginald J. Offner P,
Johnson J: Secondary abdominal compartment
syndrome is a highly lethal event. The American J of
Surgery. 2001; 182: 645-648.
4. Sheikhei RA, Heydari M, Shahbazi S. Comparison of
Intra-abdominal Pressure Measurement and
Physical Exam for Diagnosis of Surgery Indication in
Patients with Abdominal Compartment Syndrome
due to Blunt Trauma. Journal of Kerman University
of Medical Sciences. 2011;18(3):271-8.
5. Waele J, Lae I, Kirkpatrick A, Hoste E: Intra-abdominal
Hypertension and Abdominal Compartment
Syndrome. Am J Kidney Dis. 2010; 57(1): 159-169.
6. Cothren C, Moore E, Johnson J, Moore J: Outcomes
in surgical versus medical patients with the
secondary abdominal compartment syndrome. The
American J of Surgery. 2007; 194: 804-808.
7. Scheppach W. Abdominal compartment syndrome.
Best Practice & Research Clinical Gastroenterology.
2009; 23: 25-33.
8. Kowal Vern A, Ortegel J, Bourdon P, Chakrin A,
Latenser B, Kimball D, et al. Elevated cytokine
levels in peritoneal fluid from burned patients with
intra-abdominal hypertension and abdominal
compartment syndrome. Burns. 2006; 32: 563-569.
9. Ganeshanantham SR, Walsh, K. Varty. Abdominal
compartment syndrome in vascular surgery-A
review G. International J of Surgery. 2010; 8: 181-
185.
10. Peppriell J, Bacon D. Acute Abdominal
Compartment Syndrome with Pulse less Electrical
Activity during Colonoscopy with Conscious
Sedation. J of Clinical Anesthesia. 2000; 12: 216-
219.
11. Spencer P, kinsman L, Fuzzard K. A critical care
Nurses guide to intra-abdominal hypertension
compartment syndrome. Australian J critical care.
2008; 21(1): 18-28.
12. World Society of Abdominal Compartment
Syndrome Consensus Conference Definitions. In:Inaugural World Congress-Abdominal
Compartment Syndrome. 2004.
13. Malbrain M, Chiumello D, Pelosi P, Bihari D, Innes
R, Raniei V, et al. Incidence and prognosis of intraabdominal
hypertension in a mixed population of
critically ill patients: a multiple-center
epidemiological study. Crit Care Med. 2005; 33(2):
315-22.
14. Berger P, Nijsten M, Paling J. His abdominal
compartment syndrome: a complication with many
faces. The Nether land J of Medicine. 2001; 58 (1):
197-203.
15. Meier Ch, Contaldo C, Schramm R, Holstein J,
Hamacher J, Amon M, et al . A New Model for the
Study of the Abdominal Compartment syndrome in
rats. Journal of Surgical Research. 2007; 139: 209-
216.
16. Schepp W. Abdominal compartment syndrome,
best practice researched clinical gastroenterology.
The J of Trauma. 2009; 23(1): 25-33.
17. Rollins. M, Volger S. Decomppressivelaparatomy
for abdominal compartment syndrome in children:
before it is too late. J of pediatric surgery 2010;
45(6): 1324-1329.
18. Loftus I, Thompos M. The abdominal compartment
syndrome following aortic surgery. EurjVasc Surg.
2003; 20(1): 110-115.
19. Mcquillan K, Makic M, Whalen S. Trauma nursing
from resuscitation through rehabilitation. 4th ed.
Philadelphia: Saunders CO; 2009. pp. 678-704.
20. Rosen C. Emergency medicine. 7thed. Philadelphia:
Mosby CO; 2010. pp. 414-435.
21. Bouden D, Halliwell D. Emergency care and first aid
for nurses. Philadelphia: Saunders CO; 2007. pp.
186-208.
22. Smeltzer S, Bare B, Hinkle J, Cheerer K. Medical-
Surgical nursing. 11th ed. Philadelphia: Lippincott
Williams wilkins; 2008.
23. Black J M. Hawks J H. Medical-Surgical Nursing. 7th
ed. Philadelphia: Elsevier Saunders; 2005.
Published
2018-02-06
How to Cite
Sheikhi, R. A., & Heidari, M. (2018). Intra-Abdominal Pressure Monitoring By Nurses For Early Detection Of Abdominal Compartment Syndrome And Early Decompressed Laparotomy In Comparison With Need To Laparotomy By Physical Exam: Intra-Abdominal Pressure Monitoring For Early Detection Of Abdominal Compartment Syndrome. National Journal of Integrated Research in Medicine, 7(2), 18-23. Retrieved from http://www.nicpd.ac.in/ojs-/index.php/njirm/article/view/1349
Section
Original Articles