Liivi Maddison "Tissue perfusion and metabolism during intra-abdominal hypertension" | University of Tartu

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Contacts of UT units

Faculty of Arts and Humanities
Faculty phone: 
+372 737 5341
Faculty address: 
Jakobi 2, rooms 116–121, 51005 Tartu
  • Dean's Office
    Faculty phone: 
    + 372 737 5341
    Faculty address: 
    Jakobi 2, rooms 116–121, 51005 Tartu
  • Institute of History and Archaeology
    Faculty phone: 
    +372 737 5651
    Faculty address: 
    Jakobi 2, 51005 Tartu
  • Institute of Estonian and General Linguistics
    Faculty phone: 
    +372 737 5221
    Faculty address: 
    Jakobi 2, 51005 Tartu
  • Institute of Philosophy and Semiotics
    Faculty phone: 
    +372 737 5314
    Faculty address: 
    Jakobi 2, rooms 309–352, 51005 Tartu
  • Institute of Cultural Research
    Faculty phone: 
    (+372) 737 5223
    Faculty address: 
    Ülikooli 16, 51003 Tartu
  • School of Theology and Religious Studies
    Faculty phone: 
    +372 737 5301
    Faculty address: 
    Ülikooli 18–310, 50090 Tartu
  • College of Foreign Languages and Cultures
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    J. Liivi 4, 50409, Tartu
  • Viljandi Culture Academy
    Faculty phone: 
    +372 435 5232
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    Posti 1, 71004 Viljandi
Faculty of Social Sciences
Faculty phone: 
+372 737 5957
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Lossi 36, 51003 Tartu
  • Dean's Office
    Faculty phone: 
    + 372 737 5900
    Faculty address: 
    Lossi 36, 51003 Tartu
  • Institute of Education
    Faculty phone: 
    +372 737 6440
    Faculty address: 
    Salme 1a–29, 50103 Tartu
  • Johan Skytte Institute of Political Studies
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    +372 737 5582
    Faculty address: 
    Lossi 36–301, 51003 Tartu
  • School of Economics and Business Administration
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    Faculty address: 
    Narva mnt 18, 51009 Tartu
  • Institute of Psychology
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    Faculty address: 
    Näituse 2, 50409 Tartu
  • School of Law
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  • Institute of Social Studies
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Faculty of Medicine
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    Faculty address: 
    Ravila 19, 50411 Tartu
  • Institute of Biomedicine and Translational Medicine
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    Biomeedikum, Ravila 19, 50411 Tartu
  • Institute of Pharmacy
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  • Institute of Dentistry
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    Raekoja plats 6, 51003 Tartu
  • Institute of Clinical Medicine
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    Faculty address: 
    L. Puusepa 8, 50406 Tartu
  • Institute of Family Medicine and Public Health
    Faculty phone: 
    +372 737 4190
    Faculty address: 
    Ravila 19, 50411 Tartu
  • Institute of Sport Sciences and Physiotherapy
    Faculty phone: 
    +372 737 5360
    Faculty address: 
    Jakobi 5–205, 51005 Tartu
Faculty of Science and Technology
Faculty phone: 
+372 737 5820
Faculty address: 
Vanemuise 46–208, 51014 Tartu
  • Dean's Office
    Faculty phone: 
    +372 737 5820
    Faculty address: 
    Vanemuise 46–208, 51003 Tartu
  • Institute of Computer Science
    Faculty phone: 
    +372 737 5445
    Faculty address: 
    Narva mnt 18, 51009 Tartu
  • Estonian Marine Institute
    Faculty phone: 
    +372 671 8902
    Faculty address: 
    Mäealuse 14, 12618 Tallinn
  • Institute of Physics
    Faculty address: 
    W. Ostwaldi 1, 50411 Tartu
  • Institute of Chemistry
    Faculty phone: 
    +372 737 5261
    Faculty address: 
    Ravila 14a, 50411 Tartu
  • Institute of Mathematics and Statistics
    Faculty phone: 
    +372 737 5860
    Faculty address: 
    Narva mnt 18, 51009 Tartu
  • Institute of Molecular and Cell Biology
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    Riia 23, 23b–134, 51010 Tartu
  • Tartu Observatory
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  • Institute of Technology
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    Faculty address: 
    Nooruse 1, 50411 Tartu
  • Institute of Ecology and Earth Sciences
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    Faculty address: 
    Vanemuise 46, 51003 Tartu
Institutions
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    +372 737 5702
    Faculty address: 
    W. Struve 1, 50091 Tartu
  • Youth Academy
    Faculty phone: 
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    Faculty address: 
    Uppsala 10, 51003 Tartu
  • Institute of Genomics
    Faculty phone: 
    +372 737 4000
    Faculty address: 
    Riia 23b, 51010 Tartu
  • Museum
    Faculty phone: 
    +372 737 5674
    Faculty address: 
    Lossi 25, 51003 Tartu
  • University of Tartu Natural History Museum and Botanical Garden
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    Faculty address: 
    Vanemuise 46, 51003 Tartu
Support Units
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    Faculty address: 
    Ülikooli 18a, 51005 Tartu
  • Centre for Entrepreneurship and Innovation
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    Faculty address: 
    Narva mnt 18, 51009, Tartu
  • University Office in Tallinn
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    Faculty address: 
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  • Estates Office
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    Faculty address: 
    Ülikooli 18a, 51005 Tartu
  • Finance Office
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    Faculty address: 
    Jakobi 4, 51005 Tartu
  • Grant Office
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    Raekoja plats 9, 51004 Tartu
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    Faculty address: 
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    Faculty address: 
    Ülikooli 18, 50090 Tartu
  • Procurement Office
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    Ülikooli 18a, 51005 Tartu
  • Rector's Strategy Office
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    Ülikooli 18, 50090 Tartu
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  • University of Tartu Foundation
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  • View all other units

Liivi Maddison "Tissue perfusion and metabolism during intra-abdominal hypertension"

Date: 
09.06.2014 - 15:00 to 17:00

Thesis supervisors:
Professor Joel Starkopf, MD, PhD, University of Tartu
Juri Karjagin, MD, PhD, University of Tartu

Opponent:
Vladimir Cerny, MD, PhD, Charles University in Prague

Summary:
Approximately 10000 patients are hospitalised to intensive care unit every year in Estonia. One third of them develop elevated intra-abdominal pressure (IAP) i.e. intra-abdominal hypertension (IAH). IAH can lead to severe abdominal organ's dysfunction and is therefore a reason for elevated mortality. According to the severity, IAH is graded into four levels. Grade I refers to IAP levels from 12 to 15 mmHg, Grade II 16 to 20, Grade III 21 to 25, and Grade IV above 25 mmHg, respectively. The most severe form of IAH (IAP over 20 mmHg) is life-threatening abdominal compartment syndrome (ACS). Treatment of ACS is self-evident - fast and aggressive. Consequences of grade I and II IAH are not uniformly understood and the treatment recommendations are either absent or un-precisely defined.

The main aim of present study was to investigate whether grade I and II IAH causes alterations in tissue perfusion and metabolism which are not detectable with conventional methods. Early treatment of mild to moderate IAH would be necessary if tissue perfusion and metabolism are deteriorated. Tissue perfusion was evaluated in sublingual area with videomicroscope. Several researches have previously shown that gastrointestinal and sublingual region microcirculation reacts similarly and that sublingual changes describe the situation in gastrointestinal region. For tissue metabolism evaluation we used microdialysis in the abdominal rectus muscle.

Altogether 37 patients we included. Main finding of our work was that grade I or II IAH does not influence sublingual microcirculation in previously fluid-resuscitated critically ill patients. But the microcirculation was significantly altered in surgical patients, who were not allowed to eat-drink prior the elective surgery. The main finding of microdialysis study was the prevalence of anaerobic metabolism in RAM tissue during grade I and II IAH. This indicates to possible tissue hypoperfusion.

In conclusion, the results of present work accentuate, that the tissue metabolism is severely altered during grade I and II IAH, despite the lack of clearly identified clinical symptoms and therefore IAH cannot be ignored in critically ill patients.

Location: 
Prof A. Linkberg Lecture Theatre (Puusepa 8)
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