Download PDF
CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2020; 39(03): 189-191
DOI: 10.1055/s-0040-1713593
Review Article | Artigo de Revisão

Intracranial Hypertension and Intra-abdominal Pressure. Is it Worth Measuring?

Hipertensão intracraniana e pressão intra-abdominal. Vale a pena mensurar?
Simonei Bonatto
1   Postgraduation program, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
,
Danielle Pacheco Matias
2   Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
,
Leonardo Christiaan Welling
3   Neurological Surgery Department, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Patients with refractory intracranial hypertension who have already undergone all the measures recommended by the current guidelines can benefit from having their intra-abdominal pressure monitored since its increase generates hemodynamic repercussions and secondary elevation of intracranial pressure. In this context, a bibliographic research was performed on PubMed with the terms intra-abdominal pressure, abdominal compartment syndrome, intracranial pressure, intracranial hypertension. Altogether, 146 articles were observed, 87 of which were from the year 2000, and only 15 articles were considered relevant to the topic. These studies indicate that patients with refractory intracranial hypertension can benefit from the measurement of intraabdominal pressure, since there is evidence that an increase in this pressure leads to organic dysfunctions with an indirect impact on cerebral venous return and, consequently, an increase in intracranial pressure. In those who underwent decompression laparotomy, direct effects were observed in reducing intracranial hypertension and survival.

Resumo

Pacientes com hipertensão intracraniana refratária que já foram submetidos a todas as medidas preconizadas pelas diretrizes atuais podem se beneficiar do monitoramento da pressão intra-abdominal, uma vez que seu aumento gera repercussão hemodinâmica e elevação secundária da pressão intracraniana. Nesse contexto, realizou-se uma pesquisa bibliográfica no PubMed com os termos “intra-abdominal pressure,” “abdominal compartment syndrome,” “intracranial pressure”; “intracranial hypertension.” Ao todo, foram observados 146 artigos, dos quais 87 eram a partir do ano 2000, e apenas 15 artigos foram considerados relevantes ao tópico. Esses estudos indicam que pacientes com hipertensão intracraniana refratária podem se beneficiar da medida da pressão intra-abdominal, uma vez que existem evidências de que o aumento desta leva a disfunções orgânicas com impacto indireto no retorno venoso cerebral e, consequentemente, no aumento da pressão intracraniana. Naqueles que foram submetidos à laparotomia descompressiva, observou-se efeitos diretos na redução da hipertensão intracraniana e sobrevida.

Keywords

intra-abdominal pressure - abdominal compartment syndrome - intracranial pressure - intracranial hypertension

Palavras-chave

pressão intra-abdominal - síndrome do compartimento abdominal - pressão intracraniana - hipertensão intracraniana


Publication History

Received: 03 April 2020

Accepted: 12 May 2020

Article published online:
23 June 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil

 

  • References

  • 1 Citerio G, Vascotto E, Villa F, Celotti S, Pesenti A. Induced abdominal compartment syndrome increases intracranial pressure in neurotrauma patients: a prospective study. Crit Care Med 2001; 29 (07) 1466-1471
    CrossrefPubMedGoogle Scholar
  • 2 Giugno KM, Maia TR, Kunrath CL, Bizzi JJ. Tratamento da hipertensão intracraniana. J Pediatr (Rio J) 2003; 79 (04) 287-296
    PubMedGoogle Scholar
  • 3 Ferreira CB, Bassi E, Lucena L. , et al. Mensuração da pressão intracraniana e desfechos em curto prazo de pacientes com lesão encefálica traumática: Uma análise de propensão pareada. Rev Bras Ter Intensiva 2015; 27 (04) 315-321
    CrossrefPubMedGoogle Scholar
  • 4 Bahten LCV, Lange PAL, Alves RFF, Soares HMN, Souza TM, Bahten ACV. Síndrome compartimental abdominal: análise do conhecimento da equipe médica de um Hospital Universitário de Curitiba. Rev Col Bras Cir 2018; 45 (03) e1884
    PubMedGoogle Scholar
  • 5 Kamine TH, Papavassiliou E, Schneider BE. Effect of abdominal insufflation for laparoscopy on intracranial pressure. JAMA Surg 2014; 149 (04) 380-382
    CrossrefPubMedGoogle Scholar
  • 6 Malbrain ML, De Laet IE, De Waele JJ, Kirkpatrick AW. Intra-abdominal hypertension: definitions, monitoring, interpretation and management. Best Pract Res Clin Anaesthesiol 2013; 27 (02) 249-270
    CrossrefPubMedGoogle Scholar
  • 7 Deeren DH, Dits H, Malbrain MLNG. Correlation between intra-abdominal and intracranial pressure in nontraumatic brain injury. Intensive Care Med 2005; 31 (11) 1577-1581
    CrossrefPubMedGoogle Scholar
  • 8 Scalea TM, Bochicchio GV, Habashi N. , et al. Increased intra-abdominal, intrathoracic, and intracranial pressure after severe brain injury: multiple compartment syndrome. J Trauma 2007; 62 (03) 647-656 , discussion 656
    CrossrefPubMedGoogle Scholar
  • 9 Joseph DK, Dutton RP, Aarabi B, Scalea TM. Decompressive laparotomy to treat intractable intracranial hypertension after traumatic brain injury. J Trauma 2004; 57 (04) 687-693 , discussion 693–695
    CrossrefPubMedGoogle Scholar
  • 10 Villaça MP, Mantovani M. Comportamento da pressão intracraniana, da perfusão cerebral e dos parâmetros hemodinâmicos durante a síndrome do compartimento abdominal em cães. Rev Col Bras Cir 2006; 33 (04) 211-214
    CrossrefPubMedGoogle Scholar
  • 11 Zampieri FG, Almeida JR, Schettino GP, Park M, Machado FS, Azevedo LC. Factors associated with variation in intracranial pressure in a model of intra-abdominal hypertension with acute lung injury. Rev Bras Ter Intensiva 2011; 23 (02) 164-169
    PubMedGoogle Scholar
  • 12 Depauw PRAM, Groen RJM, Van Loon J, Peul WC, Malbrain MLNG, De Waele JJ. The significance of intra-abdominal pressure in neurosurgery and neurological diseases: a narrative review and a conceptual proposal. Acta Neurochir (Wien) 2019; 161 (05) 855-864
    CrossrefPubMedGoogle Scholar
  • 13 Milanesi R, Caregnato RCA. Intra-abdominal pressure: an integrative review. Einstein (Sao Paulo) 2016; 14 (03) 423-430
    CrossrefPubMedGoogle Scholar
  • 14 Sosa G, Gandham N, Landeras V, Calimag AP, Lerma E. Abdominal compartment syndrome. Dis Mon 2019; 65 (01) 5-19
    CrossrefPubMedGoogle Scholar
  • 15 Dorfman JD, Burns JD, Green DM, DeFusco C, Agarwal S. Decompressive laparotomy for refractory intracranial hypertension after traumatic brain injury. Neurocrit Care 2011; 15 (03) 516-518
    CrossrefPubMedGoogle Scholar