• Title/Summary/Keyword: abdominal pressure

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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.

The Effect of Body Mass Index on Intra-Abdominal Pressure and Blood Loss in Lumbar Spine Surgery

  • Han, In-Ho;Son, Dong-Wuk;Nam, Kyoung-Hyup;Choi, Byung-Kwan;Song, Geun-Sung
    • Journal of Korean Neurosurgical Society
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    • v.51 no.2
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    • pp.81-85
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    • 2012
  • Objective : The purpose of this prospective study was to evaluate the effects of body mass index (BMI) on intra-abdominal pressure (IAP) and intraoperative blood loss (IBL) during lumbar spinal surgery. Methods : Thirty patients scheduled for single level posterior lumbar interbody fusion were allocated equally to a normal group (Group 1, BMI;$18.5-22.9kg/m^2$), an overweight group (Group 2, BMI; $23-24.9kg/m^2$), and an obese group (Group 3, BMI; $25.0-29.9kg/m^2$) according to BMI. IAP was measured using a urinary bladder catheter; 1) supine after anesthesia induction, 2) prone at skin incision, 3) prone at the end of surgery. In addition, IBL was also measured in the three groups. Results : IAP in the supine position was not significantly different in groups 1, 2, and 3 (2.7 mm Hg, 3.0 mm Hg, and 4.2 mm Hg, respectively) ($p$=0.258), and IAP in the prone position at incision increased to 7.8 mm Hg, 8.2 mm Hg, and 10.4 mm Hg, respectively, in the three groups, and these intergroup differences were significant, especially for Group 3 ($p$=0.000). IAP at the end of surgery was slightly lower (7.0 mm Hg, 7.7 mm Hg, and 9.2 mm Hg, respectively). IBLs were not significantly different between the three groups. However, IBLs were found to increase with IAP in the prone position ($p$=0.022) and BMI ($p$<0.05). Conclusion : These results show that BMI affects IAP in the prone position more than in the supine position during lumbar spinal surgery. In addition, IBLs were found to increase with IAP in the prone position and with BMI. Thus, IBLs can be expected to be higher in morbidly obese patients due to an increased IAP.

A Study on Three Cases of Uterine Myoma (자궁근종 3례에 대한 임상연구)

  • Yoo, Dong-youl
    • Journal of Haehwa Medicine
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    • v.13 no.2
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    • pp.1-10
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    • 2004
  • During the reproductive years, the most common uterine myoma are benign, but the possibility of malignancy must be considered. Generally uterine myoma are also benign, and two-thirds of these occur in women between 30 and 45 years of age. Which produce few of only mild, nonspecific symptoms. The most common symptoms include abdominal pain or discomfort, low abdominal pressure sensation, hypermenorrhea and urinary symptoms comprise. The treatment of uterine myoma is just observation, operation and taking the hormone replacement therapy in western medicine.This study is performed to evaluate the effectiveness of Resonance Therapy and herb-med on uterine myoma. After this treatment, the size of the uterine myoma were reduced with a significant data or dismissed. So it indicates Resonance Therapy and herb-med is effective on the patient with uterine myoma, but continuous observation and study are needed.

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Studied on Garment Restraint(III) - Relation between Clothing Pressure and Muscular Activity of Foundation - (의복의 구속성에 관한 연구(III) - 화운데이션의 의복압과 근활동과의 관계를 중심으로 -)

  • Shim, Boo Ja;Choi, Seon Hee
    • Journal of the Korean Society of Clothing and Textiles
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    • v.17 no.2
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    • pp.197-206
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    • 1993
  • We studied relation between the clothing pressure applied by foundations(waist nipper, girdle, body suit) on the waist of bodies and muscular activity, feeling of tightness. The main results were summerized as follows ; 1. Clothing pressure applied by foundations was high in order of girdle>waist nipper>body suit, also clothing pressure was higher back than front and side, sitting on the chair than standing posture, ventral flection than repose. Individual differences, even if size of body was equal, were shown in clothing pressure applied by foundations with subcutaneous fat's amount in measuring region. 2. The muscular activity of rectus abdominis than obliquus externus abdominis was more affected by foundations in all kinds of postures and motions. Amplitude of electromyogram was high sitting on the chair than standing posture, but there was little difference with motion variation. The wearing girdle strongly affected on the muscular activities of rectus abdominis and obliquus externus abdominis as compared with waist nipper and body suit. 3. The value for feeling of tightness by wearing waist nipper was higher than girdle and body suit. Also the case when sitting on the chair and ventral flection, the value for feeling of tightness was high. When the foundations were on the body, most tightened on the region of the body was anterior abdominal region.

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Associations between 24-hour Urine Sodium Excretion Level and Obesity-related Metabolic Risk Factors (비만인과 정상인에서 24시간 소변 내 나트륨 배출량과 비만관련 대사위험지표의 관련성)

  • Oh, Hyun Woo;Kim, Hyun Jung;Jun, Dae Won;Lee, Seung Min
    • Korean Journal of Community Nutrition
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    • v.20 no.6
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    • pp.460-467
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    • 2015
  • Objectives: Excess sodium intake has been linked to obesity and obesity-related indices. However, the scientific evidence for this association is inadequate. The purpose of this study was to investigate the association between urinary sodium excretion and obesity-related indices among Korean adults. Methods: A convenience sample of 120 subjects (60 obese and 60 non-obese subjects) were recruited applying frequency matching for sex and age between two groups. Sodium intake level was assessed through 24-hour urine collection. Obesity-related metabolic risk factors, including fasting blood lipid indices, subcutaneous and visceral fat through computed tomography (CT), insulin resistance indices, blood pressure and liver enzymes were measured in all subjects. These obesity-related metabolic risk factors were compared between obese and non-obese group according to sodium excretion levels (<110 mEq/day, 110~180 mEq/day, >180 mEq/day). Results: After adjusting for age, gender, health behaviors (smoking, exercise, drinking), and energy intake, several obesity-related metabolic risk factors, including abdominal circumference, body fat percentage, subcutaneous and visceral fat, triglyceride, and systolic blood pressure were found to be significantly deteriorated as the sodium excretion level increases. In addition, multivariate adjusted-odds ratios of abdominal obesity, high blood triglyceride, and high blood pressure were found significantly higher in the highest sodium excretion group compared to the lowest group. The mean number of metabolic syndrome risk factors was also significantly greater in the highest sodium excretion group than in the lowest group. Conclusions: The current study findings suggested that high sodium intake can affect obesity and metabolic syndrome risk negatively, implying the necessity of future research on low-sodium diet intervention in relation to obesity and related health problems.

The Effects of Preemptive Analgesia of Morphine and Ketorolac on Postoperative Pain, Cortisol, $O_2$ Saturation and Heart Rate (Morphine과 Ketorolac의 선행진통법이 수술 후 통증, 코티졸, 산소포화도 및 심박동 수에 미치는 효과)

  • Seo, Yun-Ju;Yoon, Hae-Sang
    • Journal of Korean Academy of Nursing
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    • v.38 no.5
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    • pp.720-729
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    • 2008
  • Purpose: This study investigated the preemptive analgesic effects of Morphine and Ketorolac on postoperative pain, cortisol, $O_2$ saturation and heart rate for the first 24 hr after abdominal surgery. Methods: Data collection was performed from April 1 to September 30, 2006. Forty patients undergoing a gastrectomy under general anesthesia were randomly allocated to the experimental or control group. The experimental group (20 patients) was administered Morphine and Ketorolac approximately 1 hr prior to skin incision, but the control group (20 patients) was administered Morphine and Ketorolac at peritoneum closure through a patient-controlled analgesia (PCA) pump. Postoperative pain, blood pressure, heart rate, cortisol, $O_2$ saturation, frequency of the PCA button pressed and doses of additional analgesics were observed through post operative 24 hr. Collected data was analyzed using t-test, $X^2$ test, repeated measures ANOVA, and Bonferroni methods. Results: Postoperative pain, cortisol, the frequency of PCA button pressed, and dose of additional analgesics of the experimental group were significantly lower than the control group. There were no statistical differences in blood pressure, heart rate and $O_2$ saturation between the experimental group and control group. Conclusions: We concluded that administration of morphine and ketorolac at 1 hr prior to skin incision resulted in decreasing postoperative pain, but it didn't affect blood pressure, heart rate or $O_2$ saturation for 24 hr after abdominal surgery.

Immediate Post-laparotomy Hypotension in Patients with Severe Traumatic Hemoperitoneum

  • Lee, Gil Jae;Lee, Min A;Yoo, Byungchul;Park, Youngeun;Jang, Myung Jin;Choi, Kang Kook
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.38-42
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    • 2020
  • Purpose: Immediate post-laparotomy hypotension (PLH) is a precipitous drop in blood pressure caused by a sudden release of abdominal tamponade after laparotomy in cases of severe hemoperitoneum. The effect of laparotomy on blood pressure in patients with significant hemoperitoneum is unknown. Methods: In total, 163 patients underwent laparotomy for trauma from January 1, 2013 to December 31, 2015. Exclusion criteria included the following: negative laparotomy, only a hollow viscous injury, and hemoperitoneum <1,000 mL. After applying those criteria, 62 patients were enrolled in this retrospective review. PLH was defined as a decrease in the mean arterial pressure (MAP) ≥10 mmHg within 10 minutes after laparotomy. Results: The mean estimated hemoperitoneum was 3,516 mL. The incidence of PLH was 23% (14 of 62 patients). The MAP did not show significant differences before and after laparotomy (5 minutes post-laparotomy, 67.5±16.5 vs. 68.3±18.8 mmHg; p=0.7; 10 minutes post-laparotomy, 67.5±16.5 vs. 70.4±18.8 mmHg; p=0.193). The overall in-hospital mortality was 24% (15 of 62 patients). Mortality was not significantly higher in the PLH group (two of 14 [14.3%] vs. 13 of 48 [27.1%]; p=0.33). No statistically significant between-group differences were observed in the intensive care unit and hospital stay. Conclusions: PLH may be less frequent and less devastating than it is often considered. Surgical hemostasis during laparotomy is important. Laparotomy with adequate resuscitation may explain the equivalent outcomes in the two groups.

Effects of Music Listening on Anciety in Partients betore Undergoing Hyterectomy (음악청취가 자궁절제술전 환자의 불안에 미치는 효과)

  • Park, Hyun-Sook;Chio, Euy-Soon
    • Women's Health Nursing
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    • v.3 no.1
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    • pp.72-81
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    • 1997
  • The purpose of this study was to elucidate the effects of musical listening on anxiety in patients undergoing abdominal hysterectomy. On the basis of the research criterias, 46 patients were recruited from Kang-Nam St. Mary's Hospital in Seoul from October 1 to December 31, 1995. 20 patients of them were participated as the experimental group who received musical listening session with self-selected music tapes, while 26 patients as the control group who didn't receive that session. The musical listening sessions composed of 3 periods, the pre-operation evening, just before sleeping, the operation morning. There were no differences between two groups, in terms of age education, religion, the experience of operation, the perception of uterus, and the weight(%). The State-Trait Anxiety Inventory(STAI) was used to measure anxiety on all patients. And serum cortisol levels, fasting blood sugar levels, systolic and diastolic blood pressure were collected at the day before surgery and the operation day. The results were as follows : 1. There were no significant differences in State-Anxiety between the two groups. 2. The differences of serum cortisol level between the day before surgery and the operative day were significantly lower in experimental group than in control group(P=0.03). 3. The level of fasting blood sugar was significantly decreased in experimental group(P=0.01). 4. Systolic blood pressure level was significantly decreased in experimental group(P=0.02). While Diastolic blood pressure level was not significant between two groups. It is suggested imply that the musical listening during the perioperative period may alleviate the perioperative anxiety levels in patients undergoing abdominal hysterectomy.

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Surgical Treatment of Renovascular Hypertension Due to Primary Arteritis (원발성 동맥염에 의한 신혈관성 고혈압의 외과적 치료 :1례 보고)

  • 김주이
    • Journal of Chest Surgery
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    • v.14 no.2
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    • pp.175-178
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    • 1981
  • Since the first report by Freeman of renal artery repair for renovascular hypertension in 1954, there has been a gradual improvement in the results of renovascular reconstruction. This is case report of renovascular hypertension due to diffuse primary arteritis, which was performed aorto-bllateral renal bypass graft with using of Y -woven dacron graft. This 33 y-o male has complained intermittent headache, facial edema & malignent hypertension symptoms for 1.5 years. He had the history of Rt. B-K amputation due to unhealed wound after trauma of the Rt. great toe about 7 years ago. The abdominal aortography revealed nearly not visualized the Rt. renal artery & severe narrowing of the Lt. renal arterly. During postop. course, Blood pressure was well controlled. At postop. 3rd week, systolic pressure was down to 130-140mmHg But, diastolic pressure was remained to 100-110mmHg. At postop. 30th day, exploration was done due to intestinal obstruction signs. But severe ischemic enteritis was occured due to fibrotic obstruction of the superior mesenteric artery. The next day, he was dead. in spite of Rt. common iliac artery-sup. mesenteric artery bypass graft.

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A Case Report of Bun-Ton Disease Treated by Yang-Ji-Tang (상복부 통증을 奔豚(奔豚)으로 진단하고 양지장(良枳場)을 투여하여 호전된 1례)

  • Seok, Seon-Hee;Park, Se-Hwan;Kim, Geun-Woo;Koo, Byung-Soo
    • Journal of Oriental Neuropsychiatry
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    • v.19 no.2
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    • pp.265-278
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    • 2008
  • Stress reaction can be shown widely in the systems of psychology, endocrinology, immunology and so on. Stress promotes catecholamine from the autonomic nerve system, and this activates the sympathetic nerve system. As the sympathetic nerve system is activated, high blood pressure, tachycardia, vertigo, anxiety, diaphoresis, myotonic reaction and others can happen. Autonomic imbalance is the syndrome that people suffer from various symptoms accompanying no organic lesions and no psychological disorders by losing the hormonies between the sympathetic and parasympathetic nerve system. We experienced a 55 year-old female who complained of sudden abdominal pain after being frightened at trouble with her husband. Her abdominal pain was very characteristic, "Something is like rising in my abdomen.", that occurred several times a day. We diagnosed 'Bun-Ton Disease' from her abdominal sign. Several oriental medicine books recorded aspects of Bun-Ton disease and treatments, we had given herbal medicine and treated acupuncture be based on those. Results from studies to date suggest the Bun-Ton Disease's main cause is fright or shock, and they stimulate releasing epinephrine or norepinephrine, that result in various symptoms. In this case report, we will present this patient's case and review the Bun-Ton Disease.

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