OBJECTIVETo establish a rabbit model of abdominal compartment syndrome (ACS) induced by prolonged intra-abdominal hypertension (IAH) and evaluate the therapeutic effect of somatostatin on ACS.

METHODSTwelve New Zealand rabbits were randomized equally into normal saline (NS) group and somatostatin group. ACS model was established by intra-abdominal bleeding (IAB) and intra-abdominal infusion with nitrogen gas to achieve an intra-abdominal pressure of 15 mmHg. The hemodynamics (SP, HR, CVP), hepatic function (ALT), renal function (BUN), antioxidation level (SOD, MDA) and blood electrolyte level (pH, [Na(+)], [Cl(-)], [CaNa(2+)], [KNa(+)]) of the rabbits were recorded 1-6 h after establishment of IAH.

RESULTSProlonged IAH caused decreased hemodynamic functions and antioxidation level as well as hyperkalemia and hypocalcemia (P<0.05), but these changes showed no significant differences between NS group and somatostatin group.

CONCLUSIONProlonged IAH causes cardiovascular function damages in rabbits possibly related to acidosis, electrolyte disturbances, and oxidative damage due to tissue ischemia and hypoxia. Somatostatin produces no obvious protective effects against the occurrence and progression of ACS.

Animals ; Disease Models, Animal ; Female ; Intra-Abdominal Hypertension ; drug therapy ; etiology ; physiopathology ; Male ; Rabbits ; Somatostatin ; therapeutic use

BACKGROUND/AIMS: Intra-abdominal hypertension (IAH) is being increasingly reported in patients with severe acute pancreatitis (SAP) with worsened outcomes. The present study was undertaken to evaluate intra-abdominal pressure (IAP) as a marker of severity in the entire spectrum of acute pancreatitis and to ascertain the relationship between IAP and development of complications in patients with SAP. METHODS: IAP was measured via the transvesical route by measurements performed at admission, once after controlling pain and then every 4 hours. Data were collected on the length of the hospital stay, the development of systemic inflammatory response syndrome (SIRS), multiorgan failure, the extent of necrosis, the presence of infection, pleural effusion, and mortality. RESULTS: In total, 40 patients were enrolled and followed up for 30 days. The development of IAH was exclusively associated with SAP with an APACHE II score > or =8 and/or persistent SIRS, identifying all patients who were going to develop abdominal compartment syndrome (ACS). The presence of ACS was associated with a significantly increased extent of pancreatic necrosis, multiple organ failure, and mortality. The mean admission IAP value did not differ significantly from the value obtained after pain control or the maximum IAP measured in the first 5 days. CONCLUSIONS: IAH is reliable marker of severe disease, and patients who manifest organ failure, persistent SIRS, or an Acute Physiology and Chronic health Evaluation II score > or =8 should be offered IAP surveillance. Severe pancreatitis is not a homogenous entity.
APACHE ; Acute Disease ; Adult ; Female ; Humans ; Intra-Abdominal Hypertension/*etiology ; Length of Stay ; Male ; Middle Aged ; Multiple Organ Failure/etiology ; Necrosis/etiology ; Pancreas/*pathology ; Pancreatitis/*complications/mortality/physiopathology ; Pleural Effusion/etiology ; Prospective Studies ; Severity of Illness Index ; Systemic Inflammatory Response Syndrome/etiology

OBJECTIVETo study risk factors for the occurrence of intra-abdominal hypertension (IAH) in children with sepsis.

METHODSA nest case-control study was employed. According to intra-abdominal pressures (IAP) measured by cystometry, 119 children with sepsis were classified into normal IAP (control, n = 80) and IAH groups (n = 39). Risk factors for the occurrence of IAH were investigated by monovariable and multivariable logistic regression analysis.

RESULTSMonovariable analysis showed that there were significant differences in pediatric critical illness score (PCIS), procalcitonin (PCT) level, PaCO(2), blood lactate level, rates of intestinal or intra-abdominal infection, ascites, gastrointestinal dysfunction, mechanical ventilation, shock and multiple organ dysfunction syndrome (MODS) between the IAH and control groups (P < 0.05). Multivariable logistic regression analysis demonstrated that decreased PCIS, MODS, shock, gastrointestinal dysfunction and ascites were major risk factors for the occurrence of IAH.

CONCLUSIONSChildren with sepsis who have decreased PCIS, MODS, shock, gastrointestinal dysfunction and ascites are at risk for the occurrence of IAH.

Child ; Child, Preschool ; Critical Illness ; Female ; Humans ; Infant ; Intra-Abdominal Hypertension ; etiology ; therapy ; Male ; Multiple Organ Failure ; complications ; Risk Factors ; Sepsis ; complications ; mortality

BACKGROUND/AIMS: Gallbladder polyps (GBP) are a common clinical finding and may possess malignant potential. We conducted this study to determine whether visceral obesity is a risk factor for GBP. METHODS: We retrospectively reviewed records of subjects who received both ultrasonography and computed tomography with measurements of the areas of visceral adipose tissue and total adipose tissue (TAT) on the same day as health checkups. RESULTS: Ninety-three of 1,615 subjects (5.8%) had GBP and were compared with 186 age- and sex-matched controls. VAT (odds ratio [OR], 2.941; 95% confidence interval [CI], 1.325 to 6.529; p=0.008 for the highest quartile vs the lowest quartile) and TAT (OR, 3.568; 95% CI, 1.625 to 7.833; p=0.002 for the highest quartile vs the lowest quartile) were independent risk factors together with hypertension (OR, 2.512; 95% CI, 1.381 to 4.569; p=0.003), diabetes mellitus (OR, 2.942; 95% CI, 1.061 to 8.158; p=0.038), hepatitis B virus positivity (OR, 3.548; 95% CI, 1.295 to 9.716; p=0.014), and a higher level of total cholesterol (OR, 2.232; 95% CI, 1.043 to 4.778; p=0.039 for <200 mg/dL vs > or =240 mg/dL). Body mass index and waist circumference were not meaningful variables. CONCLUSIONS: Visceral obesity measured by VAT and TAT was associated with GBP irrespective of body mass index or waist circumference.
Adipose Tissue/ultrasonography ; Adult ; Case-Control Studies ; Cholesterol/blood ; Diabetes Complications ; Female ; Gallbladder Diseases/blood/epidemiology/*etiology ; Hepatitis B/complications ; Humans ; Hypertension/complications ; Intra-Abdominal Fat/ultrasonography ; Male ; Middle Aged ; Obesity, Abdominal/blood/*complications/ultrasonography ; Odds Ratio ; Polyps/blood/epidemiology/*etiology ; Prevalence ; Retrospective Studies ; Risk Factors