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Abdominal compliance: A bench-to-bedside review.
Annika Reintam Blaser1, Martin Björck, Bart De Keulenaer
1From the Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine (A.R.B.), Lucerne Cantonal Hospital, Lucerne, Switzerland; Department of Anaesthesiology and Intensive Care (A.R.B.), University of Tartu, Tartu, Estonia; Section of Vascular Surgery (M.B.), Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Intensive Care Medicine (B.D.K., A.R.), Fremantle Hospital; and Medical School (A.R.), The University of Notre Dame Australia, Fremantle; and Schools of Surgery (B.D.K.), and School of Medicine and Pharmacology (A.R.), The University of Western Australia, Crawley; and Intensive Care Unit, Murdock Private Hospital (B.D.K.), Western Australia, Australia.
Abdominal compliance (AC), the ease of abdominal expansion, is crucial for laparoscopic surgery. Reduced AC increases risks of intra-abdominal hypertension and abdominal compartment syndrome in critically ill patients.
Area of Science:
- Physiology
- Surgical Science
Background:
- Abdominal compliance (AC) is a key factor in surgical workspace and patient outcomes.
- Reduced AC elevates risks for critically ill patients, leading to intra-abdominal hypertension and abdominal compartment syndrome.
- AC has been historically underemphasized despite its clinical significance.
Purpose of the Study:
- To elucidate the pressure-volume dynamics within the abdominal cavity.
- To explore how various conditions impact AC.
- To identify management strategies for mitigating risks associated with decreased AC.
Main Methods:
- Review of existing literature and pooling of human data.
- Analysis of abdominal compliance in patients with acute and chronic intra-abdominal hypertension.
- Characterization of the abdominal pressure-volume relationship.
Main Results:
- An exponential abdominal pressure-volume relationship was identified.
- Patients with elevated intra-abdominal pressure (IAP) exhibit reduced AC.
- Small decreases in intra-abdominal volume (IAV) can significantly improve AC and lower IAP in affected patients.
Conclusions:
- Understanding AC is vital for optimizing surgical approaches.
- Enhanced knowledge of AC can reduce complications associated with intra-abdominal hypertension.
- AC is a dynamic and critical component of intra-abdominal pressure management.
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