Both Primary and Secondary Abdominal Compartment Syndrome can be Predicted Early and are Harbingers of Multiple Organ Failure

Abdominal compartment syndrome (ACS) is a progressively increasing intraabdominal pressure of more than 20 mm Hg with new-onset thoracoabdominal organ dysfunction. Primary abdominal compartment syndrome means increased pressure due to injury or disease in the abdominopelvic region. Secondary abdominal compartment syndrome means disease originating from outside the abdomen, such as significant burns or sepsis. As the pressure inside the abdomen increases, organ failure occurs, and the kidneys and lungs are the most frequently affected. Managements of ACS are multidisciplinary. Conservative treatment with adequate volume supple and with aggressive hemodynamic support is the first step. Decompressive laparotomy with open abdomen is indicated when ACS is refractory to conservative treatment and complicated with multiple organ failure. ACS can result in a high mortality rate, and successful treatment requires cooperation between physicians, intensivists, and surgeons.

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Preformed Silastic Silos in the Management of Necrotizing Enterocolitis

The American Surgeon ◽

10.1177/000313480907500212 ◽

2009 ◽

Vol 75 (2) ◽

pp. 172-174

Author(s):

Amy B. Moore ◽

Don K. Nakayama

Keyword(s):

Compartment Syndrome ◽

Abdominal Compartment Syndrome ◽

Necrotizing Enterocolitis ◽

Clinical Status ◽

Intestinal Resection ◽

Multiple Organ ◽

Clinical Syndrome ◽

Abdominal Pressure ◽

Definitive Surgery ◽

Abdominal Compartment

Necrotizing enterocolitis (NEC) is sometimes complicated by abdominal compartment syndrome, a clinical syndrome characterized by multiple organ dysfunction that arises as a consequence of increased intra-abdominal pressure. The evolving clinical picture of NEC sometimes requires “second-look” operations done after initial abdominal exploration to more accurately gauge the optimal extent of surgery. Placing intestines in a preformed, spring-loaded, transparent Silastic silo, traditionally used in the staged treatment of gastroschisis, addresses both situations: decompression of the abdomen and allowing periodic inspection of the intestines. Standard silos were used in three infants with advanced (Bell Class 3) NEC without perforation before definitive surgery. Clinical indices and laboratory values were recorded during the patients’ hospital courses. All three infants had extensive areas of intestinal ischemia and necrosis. FiO2, acidosis, and urinary output remained stable or improved in two patients. Silo placement corrected abdominal compartment syndrome in the third patient. Intestinal resection was required in all infants, each achieving surgical resolution of NEC. Two patients ultimately died from respiratory and neurologic complications. Application of a silo addresses abdominal compartment syndrome as a complication of NEC and allows continual inspection of the intestines. Physiological indices may improve the patient's overall clinical status.

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Relationship between Sequential Organ Failure Assessment (SOFA) and intra-abdominal pressure in intensive care unit

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202014000400007 ◽

2014 ◽

Vol 27 (4) ◽

pp. 256-260 ◽

Cited By ~ 1

Author(s):

Gustavo Rocha Costa de FREITAS ◽

Olival Cirilo Lucena da FONSECA-NETO ◽

Carla Larissa Fernandes PINHEIRO ◽

Luiz Clêiner ARAÚJO ◽

Roberto Esmeraldo Nogueira BARBOSA ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Sequential Organ Failure Assessment ◽

Compartment Syndrome ◽

Organ Failure ◽

Abdominal Compartment Syndrome ◽

Abdominal Pressure ◽

Abdominal Hypertension ◽

Failure Assessment ◽

Abdominal Compartment

BACKGROUND: Patients in the intensive care unit are at risk of developing intra-abdominal hypertension and abdominal compartment syndrome. AIM: To describe the relation between Sequential Organ Failure Assessment (SOFA) vs. intra-abdominal pressure and the relation between SOFA and risk factors for intra-abdominal hypertension. METHOD: In accordance with the recommendations of the World Society of the Abdominal Compartment Syndrome, the present study measured the intra-abdominal pressure of patients 24 h and 48 h after admission to the unit and calculated the SOFA after 24 h and 48 h. Data was collected over two-month period. RESULTS: No correlation was found between SOFA and intra-abdominal pressure. Seventy percent of the patients were men and the mean age was 44 years, 10% had been referred from general surgery (with a mean intra-abdominal pressure of 11) and 65% from neurosurgery (with a mean intra-abdominal of 6.7). Only three (7.5%) presented with intra-abdominal hypertension. The highest SOFA was 15 and the most frequent kind of organ failure was neurological, with a frequency of 77%. There was a strong correlation between the SOFA after 24 h and 48 h and peak respiratory pressure (ρ=0.43/p=0.01; ρ=0.39/p=0.02). CONCLUSION: No correlation was found between SOFA and intra-abdominal pressure in the patients covered by the present study. However, it is possible in patients undergoing abdominal surgery or those with abdominal sepsis. Não houve correlação entre o SOFA e a pressão intra-abdominal nos pacientes aqui estudados; contudo, sinalizou ser possível em pacientes com operação abdominal ou naqueles com sepse abdominal.

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ORTHOPAEDIC EMERGENCY CASES AT HASAN SADIKIN HOSPITAL BANDUNG CAUSED BY TRADITIONAL BONE SETTER PRACTICE

(JOINTS) Journal Orthopaedi and Traumatology Surabaya ◽

10.20473/joints.v7i1.2018.77-84 ◽

2019 ◽

Vol 7 (1) ◽

pp. 77

Author(s):

Hantonius Hantonius ◽

Hermawan Nagar Rasyid ◽

Gibran Tristan Alpharian

Keyword(s):

Multiple Organ Failure ◽

Compartment Syndrome ◽

Organ Failure ◽

Descriptive Study ◽

Developing Nations ◽

Multiple Organ ◽

Infected Wound ◽

Emergency Ward ◽

Successful Operation ◽

Observational Descriptive Study

Traditional bone setting is common in developing nations. The practitioners are barely educated and rely so much on experience. Although they are popular in public, traditional bone setter are known in hospital practice for their failures and complications which present to hospitals for remediation.The purpose of the study is to report the orthopaedic emergency cases caused by the practice of traditional bone setter. This was an observational descriptive study, 36 patients with complications after practice of traditional bone setters and subsequently presented to emergency ward in Hasan Sadikin Hospital between 1st January 2015 and 31st August 2017 were evaluated.Among emergecy orthopaedic cases at Hasan Sadikin Hospital caused by bonesetter practice, compartment syndrome and gangrene are the most common complications occured. Twenty patients (56%) with infected wound and compartment syndrome had successful operation., thirteen patients (36%) with gangrene of the extremities had amputations, and three patients (11%) with multiple organ failure died. Twelve percent of amputations in our centre were related to bonesetter practice.The result of this study indicates that traditional bone setters practice may caused patients to develop complications, lose their limbs even lives due to inappropriate treatments.

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Intra-Abdominal Hypertension and Abdominal Compartment Syndrome in Association with Ruptured Abdominal Aortic Aneurysm in the Endovascular Era: Vigilance Remains Critical

Critical Care Research and Practice ◽

10.1155/2012/151650 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Matthew C. Bozeman ◽

Charles B. Ross

Keyword(s):

Compartment Syndrome ◽

Abdominal Compartment Syndrome ◽

Expectant Management ◽

Multiple Organ ◽

Abdominal Wound ◽

Vascular Events ◽

Abdominal Aortic ◽

Decompressive Laparotomy ◽

Abdominal Hypertension ◽

Abdominal Compartment

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are common complications of ruptured abdominal aortoiliac aneurysms (rAAAs) and other abdominal vascular catastrophes even in the age of endovascular therapy. Morbidity and mortality due to systemic inflammatory response syndrome (SIRS) and multiple organ failure (MOF) are significant. Recognition and management of IAH are key critical care measures which may decrease morbidity and improve survival in these vascular patients. Two strategies have been utilized: expectant management with prompt decompressive laparotomy upon diagnosis of threshold levels of IAH versus prophylactic, delayed abdominal closure based upon clinical parameters at the time of initial repair. Competent management of the abdominal wound with preservation of abdominal domain is also an important component of the care of these patients. In this review, we describe published experience with IAH and ACS complicating abdominal vascular catastrophes, experience with ACS complicating endovascular repair of rAAAs, and techniques for management of the abdominal wound. Vigilance and appropriate management of IAH and ACS remains critically important in decreasing morbidity and optimizing survival following catastrophic intra-abdominal vascular events.

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