Hipertensão intra-abdominal e síndrome do compartimento abdominal no paciente grave
Palavras-chave:
síndrome do compartimento abdominal, pressão intra-abdominal, paciente críticoResumo
Introdução: hipertensão intra-abdominal e síndrome do compartimento abdominal implicam um prognóstico sério.
Objetivo: sistematizar conteúdos essenciais relacionados ao diagnóstico e tratamento dessas emergências médicas.
Método: na Faculdade de Ciências Médicas de Guantánamo, entre janeiro e julho de 2019, foi realizada uma revisão narrativa sobre o assunto, através de uma busca em bases de dados eletrônicas (Biblioteca Virtual em Saúde): LILACS, PubMed, SciELO, ClinicalKey, REDALYC, Scopus, Cochrane.
Resultados: foram localizados 125 documentos e escolhidos 25 relevantes para a finalidade da revisão. As informações foram estruturadas nos seguintes aspectos: definição, fisiopatologia, etiologia, diagnóstico e tratamento.
Conclusões: foi preparado um referencial teórico útil para estudantes e médicos de clínica geral para se preparar sobre o assunto. Foram identificadas controvérsias sobre a eficácia do uso de medicamentos sedativos, analgésicos, procinéticos, albumina e diuréticos, terapia de reposição renal e descompressão gástrica e colônica para tratamento médico, o impacto dos tratamentos cirúrgicos na sobrevida dos pacientes e o efeito da comorbidade do paciente, da doença causadora, da janela do tempo de diagnóstico e tratamento nos resultados terapêuticos dessas emergências médicas.
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Referências
1. Reintam BA, Regli A, De Keulenaer B, et al. Incidence, risk factors, and outcomes of intra-abdominal hypertension in critically ill patients a prospective multicenter study (IROI study). Crit Care Med [en línea]. 2019 [citado 18 Ago 2019]; 47:535-42. DOI: http://dx.doi.org/10.1097/CCM.0000000000003623
2. Chandra R, Jacobson RA, Poirier J, Millikan K, Robinson E, Siparsky N. Successful non-operative management of intraabdominal hypertension and abdominal compartment syndrome after complex ventral hernia repair: a case series. Am J Surg [en línea]. 2018 Oct [citado 18 Ago 2019]; 216(4):819-823. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/30243791
3. Sánchez MA, Castellanos G, Badenesc R, Conejero R. Síndrome compartimental abdominal y síndrome de distrés intestinal agudo. Med Intensiva [en línea]. 2016 [citado 18 Ago 2019]; 37(2):99-109. DOI: http://dx.doi.org/10.1016/j.medin.2011.11.019
4. Mesa IO, Ferrer RH, Travieso PG, Mato RA, González MEM. Comportamiento de la presión intrabdominal en el abdomen agudo quirúrgico. Rev Cubana Cir [en línea]. 2018 [citado 18 Ago 2019]; 56(3):1-10. Disponible en: http://www.redalyc.org/articulo.oa?id=281254492004
5. Gupta HP, Khichar PR, Porwal R, Singh A, Sharma AK, Beniwal M, et al. The duration of intra-abdominal hypertension and increased serum lactate level are important prognostic markers in critically ill surgical patient's Outcome: A prospective, observational study. Niger J Surg [en línea]. 2019 Jun [citado 18 Ago 2019]; 25(1):1-8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6452757/
6. Pérez PJ, Barletta FR, Castro VG, Barletta FJB, Castillo FF, Barletta CJ. Mecanismos fisiopatológicos implicados en el síndrome compartimental abdominal. Rev Finlay [en línea]. 2018 [citado 18 Ago 2019]; 8(1):46-58. Disponible en: http://scielo.sld.cu/pdf/rf/v8n1/rf06108.pdf
7. Thabet FC, Ejike JC. Intra-abdominal hypertension and abdominal compartment syndrome in pediatrics. A review. J Crit Care [en línea]. 2017 Jun [citado 18 Ago 2019]; 41:275-282. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/28614762
8. Roberts DJ, Ball CG, Kirkpatrick AW. Increased pressure within the abdominal compartment: intra-abdominal hypertension and the abdominal compartment syndrome. Curr Opin Crit Care [en línea]. 2016 [citado 18 Ago 2019]; 22(2):174-85. DOI: http://dx.doi.org/10.1097/MCC.0000000000000289
9. World Society of the Abdominal Compartment Syndrome (WSACS). Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the WSACS. Int Care Med [en línea]. 2013 Jul [citado 18 Ago 2019]; 39:1190-206. Disponible en: http://www.gradeworkinggroup.org
10. Shaheen AW, Crandall ML, Nicolson NG, Smith SE, Merlotti GJ, Jalundhwala Y, et al. Abdominal compartment syndrome in trauma patients: new insights for predicting out-comes. J Emerg Trauma Shoc. [en línea]. 2016 [citado 18 Ago 2019]; 9(2):53-7. Disponible en: http://refhub.elsevier.com/S0122-7262(17)30055-1/sbref0170
11. Strang SG, Van Lieshout EM, Van Waes OJ, Verhofstad MH. Prevalence and mortality of abdominal compartment syndrome in severely injured patients: A systematic review. J Trauma Acute Care Surg [en línea]. 2016 [citado 18 Ago 2019]; 81(3):585-92. DOI: http://dx.doi.org/10.1097/TA.0000000000001133
12. Regli A, Pelosi P, Malbrain M. Ventilation in patients with intra-abdominal hypertension: what every critical care physician needs to know. Ann Intensive Care [en línea]. 2019 [citado 18 Ago 2019]; 9(52):1-19. DOI: https://doi.org/10.1186/s13613-019-0522-y
13. Carr JA. Abdominal compartment syndrome: a decade of progress. J Am Coll Surg [en línea]. 2016 [citado 18 Ago 2019]; 216(1):135-146. DOI:http://dx.doi.org/10.1016/j.jamcollsurg.2012.09.004
14. Andrew HS. Acute. Compartment Syndrome. Orthop Clin N Am [en línea]. 2016 [citado 18 Ago 2019]; 47:17-525. DOI: http://dx.doi.org/10.1016/j.ocl.2016.0 2.001
15. González SAJ, Titos GA, Cabrera SI, Aranda NJM, Romacho LL, Pitarch MM, et al. Situación actual del cierre de abdomen temporal. Cir Andal [en línea]. 2019 [citado 18 Ago 2019]; 30(1):96-100. Disponible en: https://www.asacirujanos.com/revista/completo/2019/30/61
16. Hecker A, Hecker B, Hecker M, Riedel JG, Weigand MA, Padberg W. Acute abdominal compartment syndrome: current diagnostic and therapeutic options. Langenbecks Arch Surg [en línea]. 2016 [citado 18 Ago 2019]; 401(1):15-24. Disponible en: https://emedicine.medscape.com/article/26518567-overview
17. Borre ND, Almanza HA, Dueñas CC, Ortiz RG. La monitorización intraabdominal, una medida olvidada en UCI. Acta Colomb Cuid Intens [en línea]. 2018 [citado 18 Ago 2019]; 18(1):31-42. DOI: https://doi.org/10.1016/j.acci.2017.10.009
18. Hunt L, Frost SA, Newton PJ, Salamonson Y, Davidson PM. A survey of critical care nurses’ knowledge of intra-abdominal hypertension and abdominal compartment syndrome. Aust Crit Care [en línea]. 2016 [citado 18 Ago 2019]; 17(3). Disponible en: http://refhub.elsevier.com/S0122-7262(17)30055-1/sbref0275
19. Paola ALA, Solano MH, Rojas MVM. Síndrome Compartimental, generalidades, consenso diagnóstico y técnica quirúrgica. Rev Cl EMed UCR – HSJD [en línea]. 2018 [citado 18 Ago 2019]; 8(11):11-24. Disponible en: https://www.medigraphic.com/pdfs/revcliescmed/ucr-2018/ucr182e.pdf
20. Prasad GR, Subba Rao JV, Aziz A, Rashmi TM. The Role of Routine Measurement of Intra-abdominal Pressure in Preventing Abdominal Compartment Syndrome. J Indian Assoc Pediatr Surg [en línea]. 2017 Sep [citado 18 Ago 2019]; 22(3):134-138. DOI: http://dx.doi.org/10.4103/jiaps.JIAPS_222_15
21. Van Damme L, De Waele JJ. Effect of decompressive laparotomy on organ function in patients with abdominal compartment syndrome: a systematic review and meta-analysis. Crit Care Jul [en línea]. 2018 [citado 18 Ago 2019]; 22(1):179. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/30045753
22. Gray S, Christensen M, Craft J. The gastro-renal effects of intraabdominal hypertension: Implications for critical care nurses. Intensive Crit Care Nurs [en línea]. 2018 Oct [citado 18 Ago 2019]; 48:69-74. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/29937073
23. Campos MMA, Villarreal RE, Chimal TM, Pozas MJA. Presión intraabdominal como predictor de cirugía en pacientes con dolor abdominal agudo. Rev Med Inst Mex Seg Soc [en línea]. 2016 [citado 18 Ago 2019]; 54(3):280-5. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/27100971
24. Reintam BAR, Malbrain MLNG, Starkopf J, Fruhwald S, De Waele J, Braun JP, et al. Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM working group on abdominal problems. Int Care Med [en línea]. 2019 [citado 18 Ago 2019]; 38(3):384-94. DOI: http://doi:10.1007/s00134-011-2459-y
25. Rogers WK, Garcia L. Intra-Abdominal Hypertension, Abdominal Compartment Syndrome, and the Open Abdomen. Chest [en línea]. 2018 Aug [citado 18 Ago 2019]; 153(1):238-250. DOI: http://dx.doi.org/10.1016/j.chest.2017.07.023
2. Chandra R, Jacobson RA, Poirier J, Millikan K, Robinson E, Siparsky N. Successful non-operative management of intraabdominal hypertension and abdominal compartment syndrome after complex ventral hernia repair: a case series. Am J Surg [en línea]. 2018 Oct [citado 18 Ago 2019]; 216(4):819-823. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/30243791
3. Sánchez MA, Castellanos G, Badenesc R, Conejero R. Síndrome compartimental abdominal y síndrome de distrés intestinal agudo. Med Intensiva [en línea]. 2016 [citado 18 Ago 2019]; 37(2):99-109. DOI: http://dx.doi.org/10.1016/j.medin.2011.11.019
4. Mesa IO, Ferrer RH, Travieso PG, Mato RA, González MEM. Comportamiento de la presión intrabdominal en el abdomen agudo quirúrgico. Rev Cubana Cir [en línea]. 2018 [citado 18 Ago 2019]; 56(3):1-10. Disponible en: http://www.redalyc.org/articulo.oa?id=281254492004
5. Gupta HP, Khichar PR, Porwal R, Singh A, Sharma AK, Beniwal M, et al. The duration of intra-abdominal hypertension and increased serum lactate level are important prognostic markers in critically ill surgical patient's Outcome: A prospective, observational study. Niger J Surg [en línea]. 2019 Jun [citado 18 Ago 2019]; 25(1):1-8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6452757/
6. Pérez PJ, Barletta FR, Castro VG, Barletta FJB, Castillo FF, Barletta CJ. Mecanismos fisiopatológicos implicados en el síndrome compartimental abdominal. Rev Finlay [en línea]. 2018 [citado 18 Ago 2019]; 8(1):46-58. Disponible en: http://scielo.sld.cu/pdf/rf/v8n1/rf06108.pdf
7. Thabet FC, Ejike JC. Intra-abdominal hypertension and abdominal compartment syndrome in pediatrics. A review. J Crit Care [en línea]. 2017 Jun [citado 18 Ago 2019]; 41:275-282. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/28614762
8. Roberts DJ, Ball CG, Kirkpatrick AW. Increased pressure within the abdominal compartment: intra-abdominal hypertension and the abdominal compartment syndrome. Curr Opin Crit Care [en línea]. 2016 [citado 18 Ago 2019]; 22(2):174-85. DOI: http://dx.doi.org/10.1097/MCC.0000000000000289
9. World Society of the Abdominal Compartment Syndrome (WSACS). Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the WSACS. Int Care Med [en línea]. 2013 Jul [citado 18 Ago 2019]; 39:1190-206. Disponible en: http://www.gradeworkinggroup.org
10. Shaheen AW, Crandall ML, Nicolson NG, Smith SE, Merlotti GJ, Jalundhwala Y, et al. Abdominal compartment syndrome in trauma patients: new insights for predicting out-comes. J Emerg Trauma Shoc. [en línea]. 2016 [citado 18 Ago 2019]; 9(2):53-7. Disponible en: http://refhub.elsevier.com/S0122-7262(17)30055-1/sbref0170
11. Strang SG, Van Lieshout EM, Van Waes OJ, Verhofstad MH. Prevalence and mortality of abdominal compartment syndrome in severely injured patients: A systematic review. J Trauma Acute Care Surg [en línea]. 2016 [citado 18 Ago 2019]; 81(3):585-92. DOI: http://dx.doi.org/10.1097/TA.0000000000001133
12. Regli A, Pelosi P, Malbrain M. Ventilation in patients with intra-abdominal hypertension: what every critical care physician needs to know. Ann Intensive Care [en línea]. 2019 [citado 18 Ago 2019]; 9(52):1-19. DOI: https://doi.org/10.1186/s13613-019-0522-y
13. Carr JA. Abdominal compartment syndrome: a decade of progress. J Am Coll Surg [en línea]. 2016 [citado 18 Ago 2019]; 216(1):135-146. DOI:http://dx.doi.org/10.1016/j.jamcollsurg.2012.09.004
14. Andrew HS. Acute. Compartment Syndrome. Orthop Clin N Am [en línea]. 2016 [citado 18 Ago 2019]; 47:17-525. DOI: http://dx.doi.org/10.1016/j.ocl.2016.0 2.001
15. González SAJ, Titos GA, Cabrera SI, Aranda NJM, Romacho LL, Pitarch MM, et al. Situación actual del cierre de abdomen temporal. Cir Andal [en línea]. 2019 [citado 18 Ago 2019]; 30(1):96-100. Disponible en: https://www.asacirujanos.com/revista/completo/2019/30/61
16. Hecker A, Hecker B, Hecker M, Riedel JG, Weigand MA, Padberg W. Acute abdominal compartment syndrome: current diagnostic and therapeutic options. Langenbecks Arch Surg [en línea]. 2016 [citado 18 Ago 2019]; 401(1):15-24. Disponible en: https://emedicine.medscape.com/article/26518567-overview
17. Borre ND, Almanza HA, Dueñas CC, Ortiz RG. La monitorización intraabdominal, una medida olvidada en UCI. Acta Colomb Cuid Intens [en línea]. 2018 [citado 18 Ago 2019]; 18(1):31-42. DOI: https://doi.org/10.1016/j.acci.2017.10.009
18. Hunt L, Frost SA, Newton PJ, Salamonson Y, Davidson PM. A survey of critical care nurses’ knowledge of intra-abdominal hypertension and abdominal compartment syndrome. Aust Crit Care [en línea]. 2016 [citado 18 Ago 2019]; 17(3). Disponible en: http://refhub.elsevier.com/S0122-7262(17)30055-1/sbref0275
19. Paola ALA, Solano MH, Rojas MVM. Síndrome Compartimental, generalidades, consenso diagnóstico y técnica quirúrgica. Rev Cl EMed UCR – HSJD [en línea]. 2018 [citado 18 Ago 2019]; 8(11):11-24. Disponible en: https://www.medigraphic.com/pdfs/revcliescmed/ucr-2018/ucr182e.pdf
20. Prasad GR, Subba Rao JV, Aziz A, Rashmi TM. The Role of Routine Measurement of Intra-abdominal Pressure in Preventing Abdominal Compartment Syndrome. J Indian Assoc Pediatr Surg [en línea]. 2017 Sep [citado 18 Ago 2019]; 22(3):134-138. DOI: http://dx.doi.org/10.4103/jiaps.JIAPS_222_15
21. Van Damme L, De Waele JJ. Effect of decompressive laparotomy on organ function in patients with abdominal compartment syndrome: a systematic review and meta-analysis. Crit Care Jul [en línea]. 2018 [citado 18 Ago 2019]; 22(1):179. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/30045753
22. Gray S, Christensen M, Craft J. The gastro-renal effects of intraabdominal hypertension: Implications for critical care nurses. Intensive Crit Care Nurs [en línea]. 2018 Oct [citado 18 Ago 2019]; 48:69-74. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/29937073
23. Campos MMA, Villarreal RE, Chimal TM, Pozas MJA. Presión intraabdominal como predictor de cirugía en pacientes con dolor abdominal agudo. Rev Med Inst Mex Seg Soc [en línea]. 2016 [citado 18 Ago 2019]; 54(3):280-5. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/27100971
24. Reintam BAR, Malbrain MLNG, Starkopf J, Fruhwald S, De Waele J, Braun JP, et al. Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM working group on abdominal problems. Int Care Med [en línea]. 2019 [citado 18 Ago 2019]; 38(3):384-94. DOI: http://doi:10.1007/s00134-011-2459-y
25. Rogers WK, Garcia L. Intra-Abdominal Hypertension, Abdominal Compartment Syndrome, and the Open Abdomen. Chest [en línea]. 2018 Aug [citado 18 Ago 2019]; 153(1):238-250. DOI: http://dx.doi.org/10.1016/j.chest.2017.07.023
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2020-02-17
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Reynosa-Aguilar Y, Elías-Armas KS, Vega-Fuentes JO, Fernández-Llombar JO, Céspedes-Pereña V. Hipertensão intra-abdominal e síndrome do compartimento abdominal no paciente grave. Rev Inf Cient [Internet]. 17º de fevereiro de 2020 [citado 22º de abril de 2025];99(1):78-8. Disponível em: https://revinfcientifica.sld.cu/index.php/ric/article/view/2688
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