Metabolic and biochemical changes in acute abdominal compartment syndrome
Authors:
Angela Molčányiová 1; Theodoz Molčányi 2; Miroslav Kitka 2
Authors place of work:
Laboratóriá Labmed a. s., Košice, 2Klinika úrazovej chirurgie, Univerzitná nemocnica L. Pasteura, Košice
1
Published in the journal:
Úraz chir. 21., 2013, č.4
Summary
INTRODUCTION:
Acute compartment syndrome is caused by rapid pressure increase within an anatomically defined space encased by considerably a more ore less non-elastic mantle. Augmentation of the inner content of abdominal cavity wrapped by structures with low elasticity leads to an intra-abdominal hypertension accompanied by decrease in perfusion pressure.
METHODS, RESULTS:
Hypoperfusion and ischemia of the bowels and other intra/retroperitoneal structures causes a metabolic malfunction associated with low energy production, free oxygen radicals and release of cytokines initiating the development of an inflammatory reaction. Ischemic and oedematous wall of the intestine looses its barrier function, which in turn leads to a translocation of endotoxines and fecal bacteria into the lymphatic system, followed by generalized inflammatory reaction. In the reperfusion phase, ischemically damaged tissues become a source of proinflammatory mediators, amplifying the systemic inflammatory reaction. Increased intra-abdominal pressure influences the functioning of organs and tissues of the abdominal cavity (solid organs – liver, spleen; hollow organs – stomach, intestine and vessels) and transmits its effects on other body compartments, as well. Typical changes being observed are hemodynamic and respiratory disorders, acute renal insufficiency etc. These are mediated by mechanical (high position of the diaphragm), humoral (vascular, immune, endocrine system) and nervesystem associated pathways.
CONCLUSIONS:
Acute abdominal compartment syndrome is a serious complication in critically ill patients because of both direct intra-abdominal effect and also its impact on remote body systems. It is not considered as an isolated illness, but rather as a syndrome created by symptoms of various origins. If not diagnosed/treated early, it leads to MODS (multiple organ dysfunction syndrome), MOFS (multiple organ failure syndrome) or even to a death.
Keywords:
abdominal compartment syndrome, intraabdominal hypertension, intra-abdominal pressure.
Zdroje
1. AHRENS, T., TUGGLE, D. Surviving severe sepsis: early recognition and treatment. Critical Care Nurse. 2004, 10, 14–5. DOI: 10.4038/slja.v16i2.352.
2. ASONITIS, S., ARGYRA, E., MARINIS, A. et al. Liver necrosis and apoptosis during increased antra-abdominal pressure alleviated by ischaemic preconditioning. Hellenic Journal of Surgery. 2012, 84, 2, 106–112. ISSN 0018-0092.
3. BAGGOT, M. G. Abdominal blow-out: a concept. Curr Res Anesth Analg. 1951, 30, 5, 295–299. PMID: 14879532.
4. BALOGH, Z. S., McKINLEY, B. A., HOLCOMB, J. B. et al. Both primary and secondary abdominal compartment syndrome can be predicted early and are harbingers of multiple organ failure. J Trauma. 2003, 54, 5, 848–861. ISSN 00225282.
5. BERSTEN, A., SIBBALD, W. J. Acute lung injury in septic shock. Crit Care Clin. 1989, 5, 1, 49–79. ISSN 07490704.
6. BERT, P. Lessons on the physiology of respiration. Paris: Baillière, 1870. 588 s.
7. BODNÁR, Z. Intra-Abdominal Hypertension and Abdominal Compartment Syndrome in Critically III Surgical Patients (Special Findings in Severe Acute Pancreatitis). In: InTech [online]. Mar 2, 2012 [cit. 2013-04-29]. Dostupné z: <http://cdn.intechopen.com/pdfs/31141/InTech-Intra_abdominal_hypertension_and_abdominal_compartment_syndrome_in_critically_ill_surgical_patients_special_findings_in_severe_acute_pancreatitis_.pdf>.
8. BODNÁR, Z., BULYOVSZKY, I., TÓTH, D. et al. The abdominal compartment syndrome (ACS) in general surgery. Magyar sebészet. 2006, 59, 3, 152–159. ISSN 00250295.
9. BODNÁR, Z., KERESZTES, T., KOVÁCS, I. et al. Increased serum adenosine and interleukin 10 levels as new laboratory markers of increased intra-abdominal pressure. Langenbecks Arch Surg. 2010, 395, 7, 969–972. ISSN 14352451.
10. BODNÁR, Z., SIPKA, S., HAJDU, Z. The Abdominal Compartment Syndrome (ACS) in General Surgery. HepatoGastroenterology. 2008, 55, 2033–2038. ISSN 01726390.
11. BOLEY, S. J., BRANDT, L. J., SAMMARTANO, R. J. History of mesenteric ischemia. The evolution of a diagnosis and management. Surgical Clinics of North America. 1997, 77, 275–288. PMID: 9146712.
12. BUC, M. Imunológia. 1. vyd. Bratislava: Veda, vydavateľstvo SAV, 2001. 463 s. ISBN 8022406678.
13. BURCH, J. M., MOORE, E. E., MOORE, F. A. et al. The abdominal compartment syndrome. Surg Clin North Am. 1996, 4, 833–842. ISSN 00396109.
14. De LAET, I., MALBRAIN, M. L. N. G., JADOUL, J. L. et al. Renal implications of increased intra-abdominal pressure: are the kidneys the canary for abdominal hypertension? Acta Clin Belg Suppl. 2007, 62, 119–130. ISSN 05677386.
15. De WAELE, J. J., De LAET, I. Intra-abdominal hypertension and the effect of renal function. Acta Clin Belg Suppl. 2007, 2, 371–374. ISSN 05677386.
16. De WAELE, J. J., LEPPÄNIEMI, A. K. Intra-abdominal hypertension in acute pancreatitis. World J Surg. 2009, 33, 1128–1133. ISSN 14322323.
17. DEWAR, D., MOORE, F. A., MOORE, E. E., BALOGH, Z. Postinjury multiple organ failure. Injury. 2009, 40, 912–918. ISSN 18790267.
18. DIEBEL, L. N., DULCHAVSKY, S. A., BROWN, W. J. Splanchnic ischemia and bacterial translocation in the abdominal compartment syndrome. J Trauma. 1997, 43, 852–855. ISSN 00225282.
19. DIEBEL, L. N., DULCHAVSKY, S. A., WILLSON, R. F. Effect of increased intra-abdominal pressure on mesenteric arterial and intestinal mucosal blood flow. J Trauma. 1992, 33, 1, 45–49. ISSN 00225282.
20. EMERSON, H. Intra-abdominal pressures. Arch Intern Med. 1911, 7, 754-784.
21. ENGLISH, W. Abdominal compartment syndrome. In: World Federation of Societies of Anaesthesiologists [online]. Dec 1, 2008 [cit. 2013-04-29]. Dostupné z: <http://www.anaesthesiologists.org/component/joomdoc/Archive%20UiA/Update%20028%202012.pdf/detail>.
22. FIETSAM, R., JR., VILLALBA, M., GLOVER, J. L. et al. Intraabdominal compartment syndrome as a complication of ruptured abdominal aortic aneurysm repair. Am Surg. 1989, 55, 396–402. ISSN 00031348.
23. FRINK, M., PAPE, H. C., van GRIENSVEN M. et al. Influence of sex and age on mods and cytokines after multiple injuries. Shock. 2007, 27, 151–156. ISSN 10732322.
24. GROSS, R. E. A new method for surgical treatment of large omphaloceles. Surgery. 1948, 24, 277–292. ISSN 00396060.
25. GÜNTHER, A., WALMRATH, D., GRIMMINGER, F. et al. Surfactant metabolism and replacement in ARDS. In: EVANS, T. W., GRIFFITHS, M. J. D., KEOGH, B. F., eds. Acute Respiratory Distress Syndrome. Sheffield (UK): European Respiratory Monograph, 2002. 20, 119–128. ISBN 9781904097235.
26. HANSEN, P. B., HASHIMOTO, S., OPPERMANN, M. et al. Vasoconstrictor and vasodilator effects of adenosine in the mouse kidney due to preferential activation of A1 or A2 adenosine receptors. J Pharmacol Exp Ther. 2005, 315, 3, 1150–1157. ISSN 00223565.
27. HARUŠTIAK, S., KOTHAJ, P., PECHAN, J. et al. Princípy chirurgie II. 1. vyd. Bratislava: Slovak Academic Press, 2010. 848 s. ISBN 9788080950538.
28. HOUSLEY, G. D., BRINGMANN, A., REICHENBACH, A. Purinergic signalling in special senses. Trends Neurosci. 2009, 32, 128–141. ISSN 01662236.
29. CHEATHAM, M. L., WHITE, M. W., SAGRAVES, S. G. et al. Abdominal perfusion pressure: A superior parameter in the assessment of intra-abdominal hypertension. J Trauma. 2000, 49, 621–626. ISSN 00225282.
30. CHEN, H., LI, F., SUN, J. B., JIA, J. G. Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage. World J Gastroenterol. 2008, 14, 22, 3541–3548. ISSN 1007-9327.
31. JAKOB, S. M. Clinical review: Splanchnic ischaemia. Crit Care. 2002, 6, 4, 306–312. DOI: 10.1186/cc1515.
32. KRON, I. L., HARMAN, P. K., NOLAN, S. P. The measurement of intra-abdominal pressure as a criterion for abdominal re-exploration. Ann Surg. 1984, 199, 28–30. ISSN 00034932.
33. LAMBERT, D. M., MARCEAU, S., FORSE, R. A. Intra-abdominal pressure in the morbidly obese. Obes Surg. 2005, 15, 1225–1232. ISSN 09608923.
34. Le MOINE, O., STORDEUR, P., SCHANDENÉ, L. et al. Adenosine enhances IL-10 secretion by human monocytes. J Immunol. 1996, 156, 11, 4408–4414. ISSN 00221767.
35. LEE, C. C., MARILL, K. A., CARTER, W. A. et al. A current concept of trauma-induced multiorgan failure. Ann Emerg Med. 2001, 38, 2, 170–176. ISSN 01960644.
36. LENÁRTOVÁ, R. Prokalcitonín – kvantitatívne stanovenie. Labor Aktuell. 2008, 4, 14–16. ISSN 1214-7672.
37. LEWIS, J. F., JOBE, A. H. Surfactant and the adult respirator distress syndrome. Am Rev Respir Dis. 1993, 147, 1, 218–233. PMID: 8420422.
38. MAIER, B., LEFERING, R., LEHNERT, M. et al. Early versus late onset of multiple organ failure is associated with differing patterns of plasma cytokine biomarker expression and outcome after severe trauma. Shock. 2007, 28, 668–674. ISSN 10732322.
39. MALBRAIN, M. L. N. G. , CHEATHAM, M. L. et al. Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. I. Definitions. Intensive Care Med. 2006, 32, 1722–1732. ISSN 03424642.
40. MALBRAIN, M. N. L. G., CHIUMELLO, D., PELOSI, P.. 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, 315–322. ISSN 00903493.
41. MAREY, E.-J. Medical physiology on the blood circulation. Paris: A Delahaye, 1863.
42. MARTIN, T. R., MATUTE-BELLO, G. Experimental models and emerging hypotheses for acute lung injury. Crit Care Clin. 2011, 27, 735–752. ISSN 15578232.
43. McCALLION, K., HARKIN, D. W., GARDINER, K. R. Role of adenosine in immunomodulation: review of the literature. Crit Care Med. 2004, 32, 273–277. PMID: 14707591.
44. MOLČÁNYI, T., ŽIVČÁK, J., MOLČÁNYIOVÁ, A. Prejavy kompartment syndrómu. 1. vyd. Prešov: ManaCon, 2010. 308 s. ISBN 978-80-89040-37-7.
45. MOORE, E. E., BURCH, J. M., FRANCIOSE, R. J. et al. Staged physiologic restoration and damage control surgery. World J Surg. 1998, 22, 1184–1190. ISSN 03642313.
46. MOORE, F. A. The role of gastrointestinal tract postinjury multiple organ failure. Am J Surg. 1999, 178, 449–453. ISSN 0002-9610.
47. MOSSER, D. M., ZHANG, X. Interleukin-10: new perspectives on an old cytokine. Immun Rev. 2008, 226, 205–218. DOI 10.1111/j.1600-065X.2008.00706.x.
48. MOTEW, S. J., MOURELATOS, M. G., MILLER, R. N. et al. Evidence that adenosine contributes to the maintenance of hepatosplanchnic blood flow during peritoneal sepsis in rats. Shock. 1997, 7, 439–446. ISSN 10732322.
49. OGILVIE, W. H. The late complication of abdominal war wounds. Lancet. 1940, 2, 253–256. ISSN 0140-6736.
50. OZMEN, M. M., ZULFIKAROGLU, B., COL, C. et al. Effect of increased abdominal pressure on cytokines (IL-1β, IL-6, TNFα) C-reactive protein (CRP), free radicals (NO, MDA), and histology. Surg Laparosc Endosc Percutan Tech. 2009, 19, 2, 142–147. ISSN 15344908.
51. RAGHAVENDRAN, K., WILLSON, D., NOTTER, R. H. Surfactant therapy for acute lung injury and acute respiratory distress syndrome. Critical Care Clinics. 2011, 27, 525–559. ISSN 15578232.
52. RUBENFELD, G. D., CALDWELL, E., PEABODY, E. et al. Incidence and outcomes of acute lung injury. Engl J Med. 2005, 353, 16, 1685–1693. ISSN 15334406.
53. SCHEIN, M., WITTMANN, D. H., APRAHAMIAN, C. C. et al. The abdominal compartment syndrome: the physiological and clinical consequences of elevated intra-abdominal pressure. J Am Coll Surg. 1995, 180, 745–753. ISSN 10727515.
54. SIPKA, S., KOVÁCS, I., SZÁNTÓ, S. et al. Adenosine inhibits the release of interleukin-1β in activated human peripheral mononuclear cells. Cytokine. 2005, 31, 258–263. ISSN 1437-4331.
55. SPRAGG, R. G., LEWIS, J. F. Surfactant therapy in the acute respiratory distress syndrome. In: CHOI, A., eds. Acute respiratory distress syndrome. 2. vyd. New York (NY): Informa Healthcare USA, 2010. 287–312. ISBN 9781420088403.
56. SUGRUE, M. Abdominal compartment syndrome. Curr Opin Crit Care. 2005, 11, 4, 333–338. ISSN 10705295.
57. SUGRUE, M., BALOGH, Z. S., MALBRAIN, M. Intra-abdominal hypertension and renal failure. ANZ J Surg. 2004, 74, 78. ISSN 14451433.
58. TOWFIGH, S., HEISLER, T., RIGBERG, D. A. et al. Intestinal ischemia and the gut-liver axis: an in vitro model. J Surg Res. 2000, 88, 160–164. ISSN 00224804.
59. VALLON, V., MÜHLBAUER, B., OSSWALD, H. Adenosine and kidney function. Physiol Rev. 2006, 86, 901–940. ISSN 00319333.
60. WALKER, J., CRIDDLE, L. M. Pathophysiology and management of abdominal compartment syndrome. Am J Crit Care. 2003, 12, 367–371. ISSN 10623264.
61. WAUTERS, J., CLAUS, P., BROSENS, N. et al. Pathophysiology of renal hemodynamics and renal cortical microcirculation in a porcine model of elevated intra-abdominal pressure. J Trauma. 2009, 66, 713–719. ISSN 15298809.
62. WENDON, J., BIANCOFIORE. G., AUZINGER, G. Intraabdominal hypertension and the liver. In: IVATURY, R., CHEATHAM, M., MALBRAIN, M. eds. Abdominal compartment syndrome. Georgetown (TX): Landes Bioscience, 2006. s. 138–143. ISBN 1-58706-196-1.
63. ZÁVADA, J. Syndrom multiorgánové dysfunkce. 1. vyd. Praha: Grada, 2001. 254 s. ISBN 8071697818.
64. ŽIVČÁK, J., HUDÁK, R. Biomechanizmy. 1. vyd. Prešov : ManaCon, 2001. 343 s. ISBN 80-89040-06-3.
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