Effects of Increased Intra-abdominal Pressure upon Intracranial and Cerebral Perfusion Pressure before and after Volume Expansion
Published 1 June 1996
Geoffrey L. Bloomfield, Philip C. Ridings, Charles R. Blocher, Anthony Marmarou, Harvey J. Sugerman
Citations186
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Elevated IAP increases ICP and decreases CPP and cardiac index; whereas cardiac index and CPP decreased significantly and volume expansion further increases I CP yet improves CPP via its greater positive effect upon mean arterial pressure.
Abstract
Elevated IAP increases ICP and decreases CPP and cardiac index. Volume expansion further increases ICP yet improves CPP via its greater positive effect upon mean arterial pressure (*p < 0.05, analysis of variance. All measurements are mean +/- SEM in mm Hg).
Keywords
Medicine
Journal of neurosurgeryCerebral perfusion pressure: management protocol and clinical results
971 Citations1995Michael J. Rosner, Sheila D. Rosner +1 more
These results are significantly better than other reported series across GCS categories in comparisons of death rates, survival versus dead or vegetative, or favorable versus nonfavorable outcome classifications.
Annals of SurgeryThe Measurement of Intra-abdominal Pressure as a Criterion for Abdominal Re-exploration
871 Citations1984Irving L. Kron, P. Kent Harman +1 more
If intra-abdominal pressure rises above 25 mmHg in the early postoperative period and is associated with oliguria and normal blood pressure and cardiac index, the patient should undergo re-exploration and decompression of the abdomen.
Journal of Surgical ResearchHemodynamic effects of increased abdominal pressure
458 Citations1981Jack Kashtan, Jerry F. Green +2 more
The effect of increased abdominal pressure on cardiac output results from the combined effects of changes in cardiac function and venous return, the direction and magnitude of which depend on intravascular volume and the level of abdominal pressure.
Annals of SurgeryThe Staged Celiotomy for Trauma Issues in Unpacking and Reconstruction
439 Citations1993John A. Morris, Virginia A. Eddy +3 more
The important clinical events and decisions surrounding the reconstruction/unpacking portion of the staged celiotomy for trauma, including abdominal compartment syndrome (ACS), are described.
The Journal of Trauma: Injury, Infection, and Critical CareEFFECT OF INCREASED INTRA-ABDOMINAL PRESSURE ON HEPATIC ARTERIAL, PORTAL VENOUS, AND HEPATIC MICROCIRCULATORY BLOOD FLOW
406 Citations1992Lawrence N. Diebel, Robert F. Wilson +2 more
Journal of neurosurgeryEffect of mannitol on ICP and CBF and correlation with pressure autoregulation in severely head-injured patients
404 Citations1984J. Paul Muizelaar, H Lutz +1 more
The changes in intracranial pressure (ICP) and cerebral blood flow (CBF) after mannitol administration in a group of severely head-injured patients with intact or defective autoregulation is described.
Critical Care MedicineCardiovascular, pulmonary, and renal effects of massively increased intra-abdominal pressure in critically ill patients
403 Citations1989DAVID J. CULLEN, JOSEPH P. COYLE +2 more
Surgical decompression of the abdomen improved oxygenation, ventilation, cardiac output, atrial filling pressures, and urine output within 15 min, and the cardiovascular effects of massively elevated IAP compounded by the requisite supportive care may require surgical relief.
The Journal of Trauma: Injury, Infection, and Critical CareEFFECT OF INCREASED INTRA-ABDOMINAL PRESSURE ON MESENTERIC ARTERIAL AND INTESTINAL MUCOSAL BLOOD FLOW
402 Citations1992Lawrence N. Diebel, Scott A. Dulchavsky +1 more
Increased intra-abdominal pressure can cause severe intestinal ischemia, which may be more important than the cardiac, pulmonary, and renal changes usually described.
Journal of Surgical ResearchHemodynamic and respiratory alterations with increased intra-abdominal pressure
329 Citations1976J. David Richardson, J. Kent Trinkle
There was a close correspondence between intra-abdominal pressure and pressure in the inferior vena cava (as measured through a Femoral vein catheter) which suggests that monitoring pressure through the femoral vein may be a clinically useful technique for determining the level of IAP.
Annals of SurgeryAcute Renal Failure Associated with Increased Intra-abdominal Pressure
323 Citations1983William O. Richards, William A. Scovill +2 more
Renal failure secondary to increased intra-abdominal pressure has been previously produced experimentally in dogs by the intraperitoneal installation of graded amounts of saline but this is the first report of this type of renal failure in clinical practice.
Cardiopulmonary Effects of Raised Intra-Abdominal Pressure before and after Intravascular Volume Expansion
285 Citations1995Philip C. Ridings, Geoffrey L. Bloomfield +2 more
Data clarify the hemodynamic changes associated with raised IAP and indicate that care must be taken in interpreting hemodynamic measurements to determine intravascular fluid status in patients with elevated IAP.
British Journal of AnaesthesiaCARDIAC OUTPUT AND ARTERIAL BLOOD-GAS TENSION DURING LAPAROSCOPY
267 Citations1972Guy Kelman, G.H. SWAPPY +3 more
Great increases of IAP were accompanied by falls of CVP and Cj (to 4.4 l./min per 70 kg in both positions), accompanied by parallel changes of MAP and by moderate tachycardia.
Critical Care MedicineA simple technique to accurately determine intra-abdominal pressure
247 Citations1987Thomas J. Iberti, KATHY M. KELLY +3 more
It is concluded that the measurement of bladder pressure using a standard transurethral bladder catheter provides an accurate determination of intra-abdominal pressure.
PubMedIntra-abdominal compartment syndrome as a complication of ruptured abdominal aortic aneurysm repair.
247 Citations1989Robert Fietsam, Mario Villalba +2 more
The authors conclude that some patients with ruptured abdominal aortic aneurysm do not tolerate the closure of the abdominal wall, as manifested by increased ventilatory pressures, decreased oxygenation, and decreased urinary output.
The Journal of Trauma: Injury, Infection, and Critical CareMortality of Patients with Head Injury and Extracranial Injury Treated in Trauma Centers
230 Citations1989Thomas A. Gennarelli, HOWARD R. CHAMPION +3 more
Head injury is associated with more deaths than all other injuries and causes almost as many deaths as extracranial injuries and because of its high mortality, head injury is the single largest contributor to trauma center deaths.
The Journal of Trauma: Injury, Infection, and Critical CareDIAGNOSTIC LAPAROSCOPY INCREASES INTRACRANIAL PRESSURE
223 Citations1994Leon G. Josephs, Jaime R. Este-McDonald +2 more
Pneumoperitoneum during laparoscopy may increase ICP and must be used cautiously in evaluating patients with severe head injuries, independent of changes in arterial PCO2 or arterial pH.
Treatment of Increasing Intracranial Pressure Secondary to the Acute Abdominal Compartment Syndrome in a Patient with Combined Abdominal and Head Trauma
150 Citations1995Geoffrey L. Bloomfield, Joseph Dalton +4 more
The successful management of a patient with severe multisystem injury in whom abdominal decompression dramatically reduced high ICP unresponsive to medical measures is reported.
AnesthesiologyHemodynamics of Increased Intra-abdominal Pressure
140 Citations1978Michael J. Diamant, Jonathan L. Benumof +1 more
Findings indicate that in the presence of halothane anesthesia or hypovolemia, induction of pneumoperitoneum may cause severe cardiovascular depression in dogs with increased intra-abdominal pressure caused by intraperitoneal instillation of N2, N2O and CO2.
Journal of Pediatric SurgeryThe relative merits of various methods of indirect measurement of intraabdominal pressure as a guide to closure of abdominal wall defects
136 Citations1987Stuart R. Lacey, J. Bruce +7 more
Vesical and inferior vena caval (IVC) pressures were found to have good statistical correlation with IAP and should be used to evaluate IAP in the clinical setting to prevent the development of renal ischemia.
GastroenterologyHemodynamic effects of acute changes in intra-abdominal pressure in patients with cirrhosis
129 Citations1993Angelo Luca, Isabel Cirera +5 more
Brief elevations of IAP may have deletereous effects, as shown by the increase in azygos blood flow and the decrease in cardiac output and hepatic blood flow, whereas reduction of a high IAP causes the opposite changes and may be beneficial.
British Journal of AnaesthesiaHAEMODYNAMIC EFFECTS FOLLOWING SURGICAL RELEASE OF INCREASED INTRA-ABDOMINAL PRESSURE
87 Citations1987M. P. Shelly, A.A. ROBINSON +2 more
The haemodynamic indices of three patients, who developed abdominal tamponade as a result of intra-abdominal bleeding following liver transplantation, were measured on four occasions as the increased intra-ABdominal pressure was released.
The American Journal of SurgeryEmergency minilaparoscopy in abdominal trauma
82 Citations1983George Berci, Daniel Dunkelman +4 more
The number of unnecessary abdominal explorations in severely injured patients can be reduced to a negligible figure, thus decreasing morbidity, hospitalization time, and costs.
Abdominal Compartment Syndrome
77 Citations1995Jose Bendahan, Cornelis J. Coetzee +2 more
A patient who developed the classical hemodynamic, respiratory, and renal changes of abdominal compartment syndrome after surgical intervention for blunt abdominal trauma after a decompressive laparotomy improved the situation dramatically.
Journal of neurosurgeryThe physiological basis of intracranial pressure change with progressive epidural brain compression
68 Citations1977Humbert G. Sullivan, Jay Miller +3 more
A hypothesis is presented that interprets the shape of the mass lesion pressure-volume curve in terms of changes occurring in the elastic properties of the tissues surrounding the CSF space and the volume of the CSf space and will explain most of the commonly observed variations in CSF pressure.
Journal of Applied PhysiologyMechanism by which positive end-expiratory pressure increases cerebrospinal fluid pressure in dogs
67 Citations1982J M Luce, Jon S. Huseby +2 more
It is concluded that PEEP increases PCSF primarily by increasing PSVC and decreasing cerebral venous outflow and this effect is augmented if cerebral arterial inflow is increased as well.
The American Journal of SurgeryDiagnostic laparoscopy
59 Citations1989Alexander G. Nagy, David James
Based on the data, it is believed the reports in the literature are reproducible by any abdominal surgeon who uses laparoscopy as a diagnostic aid in their practice.
Archives of Neurology And PsychiatryINTERNAL JUGULAR VENOUS PRESSURE IN MAN
38 Citations1932Abraham Myerson
The object was to study the various pressures mentioned in the human being under experimental and clinical conditions.
Annals of Emergency MedicineHemodynamic effect of mannitol in a canine model of concomitant increased intracranial pressure and hemorrhagic shock
28 Citations1988R Scott Israel, John A. Marx +2 more
Mannitol ameliorates increases in ICP without compromising hemodynamic resuscitation in a canine model of concomitant increased ICP and shock.
