Electronic Thesis and Dissertation Repository

Degree

Master of Science

Program

Surgery

Supervisor

Dr. Kelly Vogt and Dr. Neil Parry

Abstract

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are increasingly recognized in critically ill patients; no non operative treatments exist, and mortality remains high.

The purpose of this thesis was to prospectively characterize the incidence of IAH in a mixed medical-surgical intensive care unit, and to test the potential therapeutic benefit of carbon monoxide (CO) and hydrogen sulphide (H2S) using an animal model of ACS. IAH was diagnosed in 30% of patients on admission; further 15% developed IAH during ICU stay. Incidence of ACS was 3%, with obesity, sepsis, mechanical ventilation and 24-hour fluid balance as independent predictors, also predicting ICU mortality. In a rat model of ACS, CO and H2S were found to improve ACS-induced microcirculatory dysfunction, inflammation, cell death and overall organ dysfunction.

IAH incidence in the critically ill is high, with its correction possibly reducing mortality. CO and H2S show promise in animal model of ACS, as potential therapeutics.


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Critical Care Commons

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