Patients with an IAP >25mmHg need abdominal decompression Michael Sugrue.

Präsentation zum Thema: "Patients with an IAP >25mmHg need abdominal decompression Michael Sugrue."—  Präsentation transkript:

1 Patients with an IAP >25mmHg need abdominal decompression Michael Sugrue

2 IAP > 25mmHg Occurs in 8% of ICU population Sugrue Arch Surg 1999

3 Prevalence of IAP >25mmHg Sugrue et al Arch Surg 1999

4 Is IAP the Key?

5 ROC curve analysis of predictors of survival from IAH Sensitivity 1- Specificity 01.0 1.0 Cheatham et al J Trauma 00

6 Heinricius Bern 1890 Ueber den einfluss der bauchfulling auf circulation und respiration Z Biol

7 Abdominal Pressure Volume Curve mmHg Litres Sugrue et al Inten Care Med 94

8 Paediatric Surgeons

9

10 *: T-test p<0.05 ANOVA p< 0.05 *: T-test p<0.05 Alk Phos and IAP

11 Histological changes after 4 hrs Liver Control 30mmHg

12 Study of compartment pressure on cardiac output Kitano JAP 1999

13 Evidence Authors n Improved Survived organ function% Burrows 410075 Ertel1710059 Fietsam 410025 Ivatury23 7165 Kron1110071 Kopelman 6 8317 Morris16 8040 Sugrue49 2061

14 Evidence Authors n Improved Survived organ function% Burrows 410075 Ertel1710059 Fietsam 410025 Ivatury23 7165 Kron1110071 Kopelman 6 8317 Morris16 8040 Sugrue49 2061

15 When IAP > 25mmHg Too LATE

16 Get Real