• Title/Summary/Keyword: IAH

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Management of Postoperative Intra-Abdominal Hypertension in a Dog Undergoing Cervical Disc Surgery

  • Kim, Dongseok;Choi, Geonho;Lee, Sang-Kwon;Lee, Kija;Lee, Won-Jae;Yun, Sung-Ho;Kwon, Young-Sam;Jang, Min
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.277-281
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    • 2022
  • The dog with tetraplegia was presented for magnetic resonance imaging and cervical ventral slot decompression. Intra-abdominal pressure (IAP) was measured every hour after surgery, along with respiratory rate, heart rate, and arterial pressure. Three hours after surgery, abdominal distension with agitation and respiratory distress were observed, and IAP rose to 12 mmHg, indicating mild intra-abdominal hypertension (IAH). Additional fentanyl and ketamine CRI did not alleviate IAH and acepromazine (0.01 mg/kg, IV) was administered to alleviate the agitation and respiratory distress. After acepromazine administration, the agitation subsided and IAP dropped to 4 mmHg. During the next 24 hours, the patient's vital signs and IAP remained stable, with normal urine output. This case report suggests the possibility of postoperative IAH monitoring in dogs. However, considering the nature of a single surgical case of cervical ventral slot, further study is required for indication of IAH monitoring.

The Effects of Intra-Abdominal Hypertension on the Prognosis of Critically Ill Patients in the Intensive Care Unit (ICU) (복강 내압 항진증이 내과계 중환자의 예후에 미치는 영향)

  • Kim, Se Joong;Seo, Jeong-Su;Son, Myeung-Hee;Kim, Soo-Youn;Jung, Ki Hwan;Kang, Eun-Hae;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je-Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Yoo, Se Hwa;Kang, Kyung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.46-53
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    • 2006
  • Background: Intra-abdominal hypertension (IAH) is defined as the presence of either an intra-abdominal pressure (IAP) ${\geq}12mmHg$ or an abdominal perfusion pressure (APP = mean arterial pressure - IAP) ${\leq}60mmHg$. Abdominal compartment syndrome (ACS) is defined as the presence of an IAP ${\geq}20mmHg$ together with organ failure. The purpose of this study was to investigate the prevalence of IAH and ACS on the day of admission and the effects of these maladies on the prognosis of critically ill patients in the ICU. Methods: At the day of admission to the ICU, the IAP was recorded by measuring the intravesicular pressure via a Foley catheter. The APACHE II and III scores were checked and SAPS II was also scored during the days the patients were in the ICU. The primary end point was the prevalence of IAH and ACS at the day of admission and the correlation between them with the 28-days mortality rate. The measurement of IAP continued until the 7th day or the day when the patient was transferred to the general ward before 7th day, unless the patient died or a Foley catheter was removed before 7th day. Patients were observed until death or the 28th day. Results: A total of 111 patients were enrolled. At the day of admission, the prevalence of IAH and ACS were 47.7% and 15.3%, respectively and the mean IAP was $15.1{\pm}8.5mmHg$. The rates of IAH for the survivor and the non-survivor groups were 56.5% and 71.4%, respectively, and these were not significantly different (p=0.593). Yet the rates of ACS between these two groups were significantly different (4/62, 6.5% vs. 13/49, 26.5%; Odds Ratio = 5.24, 95% CI = 1.58-17.30, p=0.004). Conclusion: In the present study, the prevalence of IAH was 47.7% and the prevalence of ACS was 15.3% on the day of admission. ACS was associated with a poor outcome for the critically ill patients in the ICU.

Intra-abdominal hypertension during hip arthroscopy: a case report

  • Saeyoung Kim;Hyun-Su Ri;Ji Hyun Kim;iyong Yeom
    • Journal of Yeungnam Medical Science
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    • v.40 no.1
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    • pp.102-105
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    • 2023
  • Symptomatic extravasation of irrigation fluid is a rare complication of hip arthroscopy. However, depending on the amount of fluid, intra-abdominal hypertension (IAH) may occur and even develop into abdominal compartment syndrome, which can seriously alter hemodynamic circulation. Therefore, it is important for anesthesiologists to promptly recognize the abnormal signs of IAH for early diagnosis and better clinical outcomes. Nevertheless, these signs are difficult to detect because they are usually obscured when the patient is under anesthesia and masked by surgical drapes. We report a case of IAH under general anesthesia during hip arthroscopy to highlight possible symptoms and signs.

A Study on the Effect of Happenstance Factors on the Perception of Means-Goal Relationship (우연 요인이 수단-목표 관계의 지각에 미치는 효과)

  • Lee, Byung-Kwan;Kim, Sung-Eun
    • Science of Emotion and Sensibility
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    • v.19 no.1
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    • pp.11-20
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    • 2016
  • This study was performed to examine how intrinsic acceptance for happenstance(IAH) affects evaluation of the means to achieve additional goals when the additional goals are happened to be added to the original means-goal link. Specifically, participants were asked to evaluate the effectiveness of means(e.g., exercise and saving) to achieve additional goals which are either more or less relevant to the means. The result showed that participants with high IAH were more likely to think that the original means is effective to accomplish additional goals than those with low IAH. This pattern, however, was found only when the additional goals are relevant to the means. When the relevance of the additional goals to the means was low, there was no difference in evaluation of the effectiveness of the means to achieve additional goals between participants with high and low IAH. Future research and implications of this study for goal-systems theory and intrinsic acceptance for happenstance were discussed.

Clinical Effects of Intra-Abdominal Pressure in Critically Ill Trauma Patients

  • Ryu, Dong Yeon;Kim, Hohyun;Seok, June Pill;Lee, Chan Kyu;Yeo, Kwang-Hee;Choi, Seon-Uoo;Kim, Jae-Hun;Cho, Hyun Min
    • Journal of Trauma and Injury
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    • v.32 no.2
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    • pp.86-92
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    • 2019
  • Purpose: There is increasing interest in intra-abdominal pressure (IAP) and intra-abdominal hypertension (IAH) in critically ill patients. This study investigated the effects and outcomes of elevated IAP in a trauma intensive care unit (ICU) population. Methods: Eleven consecutive critically ill patients admitted to the trauma ICU at Pusan National University Hospital Regional Trauma Center were included in this study. IAP was measured every 8-12 hours (intermittently) for 72 hours. IAP was registered as mean and maximal values per day throughout the study period. IAH was defined as $IAP{\geq}12mmHg$. Abdominal compartment syndrome was defined as $IAP{\geq}20mmHg$ plus ${\geq}1$ new organ failure. The main outcome measure was in-hospital mortality. Results: According to maximal and mean IAP values, 10 (90.9%) of the patients developed IAH during the study period. The Sequential Organ Failure Assessment (SOFA) score was significantly higher in patients with $IAP{\geq}20mmHg$ than in those with IAP <20 mmHg (16 vs. 5, p=0.049). The hospital mortality rate was 27.3%. Patients with a maximum $IAP{\geq}20mmHg$ exhibited significantly higher hospital mortality rates (p=0.006). Non-survivors had higher maximum and mean IAP values. Conclusions: Our results suggest that an elevated IAP may be associated with a poor prognosis in critically ill trauma patients.

Case of Abdominal Compartment Syndrome Treated by using a Bedside Open Linea Alba Fasciotomy (외상에 의한 후복막 출혈환자에서 발생한 복부구획증후군을 침상 옆 백선 근막 절개술로 치료한 증례)

  • Kim, Ji-Hoon T.;Han, Myung-Sik;Choi, Gun-Moo;Jang, Hyuck-Jae;Kwak, Jin-Ho;Kim, Ji-Hoon S.
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.56-59
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    • 2011
  • Abdominal compartment syndrome (ACS) is a life-threatening disorder caused by rapidly increasing intra-abdominal pressure. ACS can result in multiorgan failure and carries a mortality of 60~70%. The treatment of choice in ACS is surgical decompression. There are very few reports of ACS and experience in Korea. We report 12-year-old male patient who developed an abdominal compartment syndrome due to traffic-accident-induced retroperitoneal hematomas, Which was successfully treated by performing a bedside emergency surgical decompression with open linea alba fasciotomy with intact peritoneum. When patients do not respond to medical therapy, a decompressive laparotomy is the last surgical resort. In patients with severe abdominal compartment syndrome, the use of a linea alba fasciotomy is an effective intervention to lower intra-abdominal hypertension (IAH) without the morbidity of a laparotomy. Use of a linea alba fasciotomy as a first-line intervention before committing to full abdominal decompression in patients with abdominal compartment syndrome improves physiological variables without mortality. Consideration for a linea alba fasciotomy as a bridge before full abdominal decompression needs further evaluation in patients with polytrauma abdominal compartment syndrome.