Abdominal compartment syndrome in traumatic hemorrhagic shock: is there a fluid resuscitation inflection point associated with increased risk?

2016 ◽  
Vol 211 (4) ◽  
pp. 733-738 ◽  
Author(s):  
John O. Hwabejire ◽  
Christine E. Nembhard ◽  
Tolulope A. Oyetunji ◽  
Theodros Seyoum ◽  
Suryanarayana M. Siram ◽  
...  
Keyword(s):  
Hemorrhagic Shock ◽  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Fluid Resuscitation ◽  
Inflection Point ◽  
Increased Risk ◽  
Traumatic Hemorrhagic Shock ◽  
Abdominal Compartment

scholarly journals Interventional Treatment of Abdominal Compartment Syndrome during Severe Acute Pancreatitis: Current Status and Historical Perspective

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Dejan V. Radenkovic ◽  
Colin D. Johnson ◽  
Natasa Milic ◽  
Pavle Gregoric ◽  
Nenad Ivancevic ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Conservative Treatment ◽  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Severe Acute Pancreatitis ◽  
Fluid Resuscitation ◽  
Interventional Treatment ◽  
Invasive Approach ◽  
Aggressive Fluid Resuscitation ◽  
Abdominal Compartment

Abdominal compartment syndrome (ACS) in patients with severe acute pancreatitis (SAP) is a marker of severe disease. It occurs as combination of inflammation of retroperitoneum, visceral edema, ascites, acute peripancreatic fluid collections, paralytic ileus, and aggressive fluid resuscitation. The frequency of ACS in SAP may be rising due to more aggressive fluid resuscitation, a trend towards conservative treatment, and attempts to use a minimally invasive approach. There remains uncertainty about the most appropriate surgical technique for the treatment of ACS in SAP. Some unresolved questions remain including medical treatment, indications, timing, and interventional techniques. This review will focus on interventional treatment of this serious condition. First line therapy is conservative treatment aiming to decrease IAP and to restore organ dysfunction. If nonoperative measures are not effective, early abdominal decompression is mandatory. Midline laparostomy seems to be method of choice. Since it carries significant morbidity we need randomized studies to establish firm advantages over other described techniques. After ACS resolves efforts should be made to achieve early primary fascia closure. Additional data are necessary to resolve uncertainties regarding ideal timing and indication for operative treatment.

scholarly journals ABDOMINAL COMPARTMENT SYNDROME IN BURN PATIENTS

2018 ◽  
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Fluid Resuscitation ◽  
Burn Injury ◽  
Abdominal Pressure ◽  
Burn Patients ◽  
Severe Burn ◽  
Severe Burns ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are consistently associated with morbidity and mortality among the critically ill or injured. Thus, avoiding or potentially treating these conditions may improve patient outcomes. Despite a large number of special publications devoted to this problem, very little attention is paid to the ACS in patients with severe burn injuries. Severe burns have been shown to be a risk factor for developing IAH. Fluid resuscitation practices used in burns management further predispose patients to increase intra-abdominal pressure. The incidence of intraabdominal hypertension in patients with severe thermal injury is, according to different authors, 57.8–82.6 %. The mortality associated with IAH in severe burns is very high once organ dysfunction occurs. The purpose of this work is to collect and analyze the problem of abdominal hypertension in burn patients, as well as to draw conclusions on the prevention of this condition and improve the results of treatment of patients with severe burn injury. Intra-abdominal hypertension is a frequent complication in severe burn patients requiring massive fluid resuscitation. Development of ACS in burn patients is associated with high mortality. Prevention, early detection and proper management may avoid this usually fatal complication. Fluid resuscitation volume is directly responsible for the development of ACS in severe burned patients. Thus, optimal fluid resuscitation can be the best prevention of IAH and ACS.

Abdominal Distention

2018 ◽  
pp. 193-196
Author(s):  
Megha Rajpal
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Fluid Resuscitation ◽  
Key Management ◽  
Clinical Signs ◽  
Burn Victims ◽  
Abdominal Hypertension ◽  
The Difference ◽  
Peak Pressures ◽  
Abdominal Compartment

This chapter presents the case of a young burn victim who developed secondary abdominal compartment syndrome from fluid resuscitation. It discusses the difference between intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). It also reviews the rule of nines to calculate the percentage of body surface area burned and the Parkland formula to calculate fluid requirements in burn victims. Key management points include recognizing that patients receiving aggressive fluid resuscitation are at risk for development of IAH and ACS and knowledge of the clinical signs (low urine output, increased peak pressures, decreased tidal volumes, and hypotension) and risk factors of ACS.

scholarly journals Animal model of the abdominal compartment syndrome as a single insult and as a second insult in rats

2003 ◽  
Vol 18 (spe) ◽  
pp. 29-36 ◽  
Author(s):  
João Baptista de Rezende-Neto ◽  
Alcino Lázaro da Silva ◽  
José Renan Cunha-Melo
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Hemorrhagic Shock ◽  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Venous Pressure ◽  
Male Rats ◽  
Sprague Dawley ◽  
Mechanically Ventilated ◽  
Abdominal Compartment

The objective of this paper was to develop a clinically relevant abdominal compartment syndrome experimental model, as a single insult and as a second insult flowing hemorrhagic shock. In the single insult model, Sprague-Dawley male-rats are anesthetized, invasively monitored (central venous pressure and mean arterial pressure), and mechanically ventilated during intraperitoneal injection of air to provoke the abdominal compartment syndrome (25 mmHg) for 60 minutes. In the two insult model, Sprague-Dawley male-rats are anesthetized, invasively monitored (mean arterial pressure) and bled to a mean arterial pressure of 30 mmHg for 45 minutes. Fluid resuscitation is accomplished by infusing 0.9% sodium chloride solution (0.9% NaCl) 33.2 ml/kg plus 75% of shed blood volume. During this phase a laparotomy is performed. Two hours after the beginning of the hemorrhagic shock phase the animals are anesthetized, intubated (orotracheal), mechanically ventilated (mean arterial pressure), and the intra-abdominal pressure is increased to 25 mmHg for 60 minutes, as a second insult. A 0.9% NaCl solution is infused during this phase (45 ml/kg/h). Hemorrhagic shock and the abdominal compartment syndrome behave as clinically relevant additive insults.

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