Prophylactic open abdomen in patients with postoperative intra-abdominal hypertension 英文参考文献.docVIP

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Prophylactic open abdomen in patients with postoperative intra-abdominal hypertension 英文参考文献.doc

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Prophylactic open abdomen in patients with postoperative intra-abdominal hypertension 英文参考文献

Mentula and Lepp?niemi Critical Care 2010,14:111 /content/14/1/111 COMMENTARY Prophylactic open abdomen in patients with postoperative intra-abdominal hypertension Panu Mentula* and Ari Lepp?niemi See related research by Batacchi et al., /content/13/6/R194 pressure (IAP) and abdominal compartment syndrome Abstract (ACS) if abdominal closure is attempted by force. As Postoperative intra-abdominal hypertension (IAH) is a frequent occurrence in critically ill patients operated on for severe abdominal trauma, secondary peritonitis or ruptured abdominal aortic aneurysm. IAH may reported in the previous issue of Critical Care, Matano and colleagues [1] used the protocol for the open abdomen based on intraoperative IAP measurement after suturing of the fascia e cuto? value of IAP for the open progress to abdominal compartment syndrome (ACS) with new-onset organ dysfunction. Early recognition of IAH and interventions that prevent the development of ACS may preserve vital organ functions and increase the probability of survival. The best method to prevent postoperative ACS is to leave the abdomen open during the operation. The decision to leave the abdomen open is usually based on the surgeon’s judgment without intra-abdominal pressure (IAP) measurements during the operation. Because signi?cant morbidity and mortality are associated with the open abdomen, the measurement of IAP immediately after the fascial closure, when feasible, could o?er an objective method for determining the optimal IAP threshold for leaving the abdomen open. The management of the open abdomen requires a temporary abdominal closure (TAC) system that would ideally prevent the development of ACS and facilitate later primary fascia closure. Among several TAC systems, the most promising are those that provide negative pressure to the wound or continuous fascial traction or both. abdomen was 12 mm Hg, which was considerably lower than the recommended cuto? value