腹腔内高压的评估与处理。
Evaluation and management of intraabdominal hypertension.
机构信息
Department of Surgery George Washington University, Center for Trauma and Critical Care, Washington, District of Colombia, USA.
出版信息
Curr Opin Crit Care. 2020 Apr;26(2):192-196. doi: 10.1097/MCC.0000000000000701.
PURPOSE OF REVIEW
The purpose of this review is to provide an overview of the pathophysiology of intraabdominal hypertension/compartment syndrome and to review the recent advances in the areas of evaluation and management of this disorder.
RECENT FINDINGS
The incidence of intraabdominal hypertension (IAH) in intensive care units is as high as 45%, an incidence much higher than initially suspected. Despite decompressive laparotomy as a treatment, mortality in patients who developed abdominal compartment syndrome (ACS) requiring this procedure is as high as 50%. Some patients may be treated by fewer invasive methods, such as paracentesis, thereby avoiding the morbidity of laparotomy. Protective lung ventilation is key to managing the pulmonary sequalae of ACS. Point-of-care ultrasound can be used as an adjunctive decision-making tool.
SUMMARY
IAH is common in critically ill patients and portends a high mortality rate. Prevention and early recognition are key in minimizing adverse events.
目的综述
本文旨在概述腹腔内高压/腹腔间隔室综合征的病理生理学，并综述该疾病评估和治疗方面的最新进展。
最近的发现
重症监护病房（ICU）中腹腔内高压（IAH）的发生率高达 45%，这一发生率远高于最初的推测。尽管减压剖腹术是一种治疗方法，但需要进行此手术的腹腔间隔室综合征（ACS）患者的死亡率高达 50%。一些患者可能通过较少的侵入性方法治疗，例如经皮穿刺引流术，从而避免了剖腹术的发病率。保护性肺通气是管理 ACS 肺部后遗症的关键。即时护理超声可作为辅助决策工具。
总结
IAH 在重症患者中很常见，预示着高死亡率。预防和早期识别是将不良事件最小化的关键。
Zotero 插件