Perekhrestenko O. Monitoring and methods of correction of intraabdominal pressure in patients with hollow organs of digestive tract obstruction

The dissertation contains new approaches to diagnostics and treatment of patients with hollow organs of digestive tract obstruction based on results of intraabdominal pressure measurement, evaluation of risk factors of intraabdominal hypertension as well as methods of abdominal decompression during perioperative period. In this dissertation the incidence of intraabdominal hypertension, its influence on postoperative course as well as results of surgical treatment of patients was studied. Based on experimental results obtained, the adverse effect of intraabdominal hypertension for development of multiorgan failure and bacterial translocation was proved. A relationship between patient's tolerance to early enteral nutrition and level of intra-abdominal pressure was determined. Such results have permitted to optimize management and decrease early enteral nutrition intolerance rate from 86.4 to 16.6%. The results of investigation have proved that patients may avoid routine prophylactic use of postoperative nasogastric or nasojejunal tube placement, which should be used only when symptoms develop. The indications to decompressive laparotomy were developed. The intra-abdominal pressure management algorithm was improved.