scholarly journals ABDOMINAL DECOMPRESSION FOR ABDOMINAL COMPARTMENT SYNDROME IN CRITICALLY ILL PATIENTS: A RETROSPECTIVE STUDY

2010 ◽  
Vol 65 (6) ◽  
pp. 399-403 ◽  
Author(s):  
J. De Waele ◽  
L. Desender ◽  
I. De laet ◽  
W. Ceelen ◽  
P. Pattyn ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Compartment Syndrome ◽  
Critically Ill ◽  
Abdominal Compartment Syndrome ◽  
Critically Ill Patients ◽  
Abdominal Decompression ◽  
Abdominal Compartment

Incidence of Intra-Abdominal Hypertension and Abdominal Compartment Syndrome: A Systematic Review

2019 ◽  
Vol 36 (2) ◽  
pp. 197-202 ◽  
Author(s):  
Zaid Khot ◽  
Patrick B. Murphy ◽  
Nathalie Sela ◽  
Neil G. Parry ◽  
Kelly Vogt ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Critically Ill ◽  
Abdominal Compartment Syndrome ◽  
Critically Ill Patients ◽  
Data Extraction ◽  
Common Finding ◽  
Abdominal Pressure ◽  
Abdominal Hypertension ◽  
Definition Of ◽  
Abdominal Compartment

Objective: To determine the contemporary prevalence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome in critically ill patients. Data Sources: Medline, Embase, and Central databases. Study Selection: Studies reporting on the prevalence of IAH in consecutively admitted critically ill patients using the World Society of Abdominal Compartment Syndrome (WSACS) consensus guidelines for intra-abdominal pressure (IAP) measurement. Data Extraction: Duplicate independent review and data abstraction. Data Synthesis: The search identified 2428 titles with 6 eligible studies (n = 1965). Reported prevalence ranged from 30% to 49%. Despite abiding by the WSACS guidelines for IAP measurement, studies varied in their definition of IAH, frequency and duration of IAP measurement, and reporting of outcomes. Three of 6 studies reported that IAH, especially at higher grades, was an independent predictor of mortality. Conclusions: Intra-abdominal hypertension is a common finding in critically ill patients and may be associated with increased mortality, especially at higher grades. Further prospective research is required to examine the effect of screening and treatment of IAH on patient outcomes.

scholarly journals Intra-abdominal hypertension and abdominal compartment syndrome in critically ill patients: A narrative review of past, present, and future steps

2021 ◽  
pp. 145749692110301
Author(s):  
Marije Smit ◽  
Matijs van Meurs ◽  
Jan G. Zijlstra
Keyword(s):  
Compartment Syndrome ◽  
Critically Ill ◽  
Abdominal Compartment Syndrome ◽  
Critically Ill Patients ◽  
Open Abdomen ◽  
Surgical Decompression ◽  
Abdominal Pressure ◽  
Pressure Monitoring ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

Background and objective: Intra-abdominal hypertension is frequently present in critically ill patients and is an independent predictor for mortality. In this narrative review, we aim to provide a comprehensive overview of current insights into intra-abdominal pressure monitoring, intra-abdominal hypertension, and abdominal compartment syndrome. The focus of this review is on the pathophysiology, risk factors and outcome of intra-abdominal hypertension and abdominal compartment syndrome, and on therapeutic strategies, such as non-operative management, surgical decompression, and management of the open abdomen. Finally, future steps are discussed, including propositions of what a future guideline should focus on. Conclusions: Pathological intra-abdominal pressure is a continuum ranging from mild intra-abdominal pressure elevation without clinically significant adverse effects to substantial increase in intra-abdominal pressure with serious consequences to all organ systems. Intra-abdominal pressure monitoring should be performed in all patients at risk of intra-abdominal hypertension. Although continuous intra-abdominal pressure monitoring is feasible, this is currently not standard practice. There are a number of effective non-operative medical interventions that may be performed early in the patient’s course to reduce intra-abdominal pressure and decrease the need for surgical decompression. Abdominal decompression can be life-saving when abdominal compartment syndrome is refractory to non-operative treatment and should be performed expeditiously. The objectives of open abdomen management are to prevent fistula and to achieve delayed fascial closure at the earliest possible time. There is still a lot to learn and change. The 2013 World Society of Abdominal Compartment Syndrome guidelines should be updated and multicentre studies should evaluate the effect of intra-abdominal hypertension treatment on patient outcome.

Linea Alba Fasciotomy: A Novel Alternative in Trauma Patients with Secondary Abdominal Compartment Syndrome

2010 ◽  
Vol 76 (3) ◽  
pp. 312-316 ◽  
Author(s):  
Juan C. Duchesne ◽  
Meghan P. Howell ◽  
Calvin Eriksen ◽  
Georgia M. Wahl ◽  
Kelly V. Rennie ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Volume Index ◽  
Trauma Patients ◽  
Linea Alba ◽  
Physiological Variables ◽  
Abdominal Hypertension ◽  
Polytrauma Patients ◽  
Abdominal Decompression ◽  
Abdominal Compartment

Polytrauma patients needing aggressive resuscitation can develop intra-abdominal hypertension (IAH) with subsequent secondary abdominal compartment syndrome (SACS). After patients fail medical therapy, decompressive laparotomy is the surgical last resort. In patients with severe pancreatitis SACS, the use of linea alba fasciotomy (LAF) is an effective intervention to lower IAH without the morbidity of laparotomy. A pilot study of LAF was designed to evaluate its benefit in patients with SACS polytrauma. We conducted an observational study of blunt injury polytrauma patients undergoing LAF. Variables measured before and after LAF included intra-abdominal pressure (IAP, mmHg), abdominal perfusion pressure (APP, mmHg), right ventricular end diastolic volume index (RVEDVI, mL/m2), and ejection fraction. Of the five trauma patients with SACS, the mean age was 36 ± 17, four (80%) male with an Injury Severity Score of 27 ± 9. Pre- and post-LAF, IAP was 20.6 ± 4.7 and 10.6 ± 2.7 ( P < 0.0001), APP 55.2 ± 5.5 and 77.6 ± 7.1 ( P < 0.0001), RVEDVI 86.4 ± 9.3 and 123.6 ± 11.9 ( P < 0.0001), and EF 27.6 ± 4.2 and 40.8 ± 5 ( P < 0.0001), respectively. One patient needed full decompression for bile ascites from unrecognized liver injury. Linea alba fasciotomy, as a first-line intervention before committing to full abdominal decompression in patients with SACS trauma, improved physiological variables without mortality Consideration for LAF as a bridge before full abdominal decompression needs further evaluation in patients with polytrauma SACS.

scholarly journals The Abdomen in “Thoracoabdominal” Cannot Be Ignored: Abdominal Compartment Syndrome Complicating Extracorporeal Life Support

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Arthur J. Lee ◽  
Bryan J. Wells ◽  
Rosaleen Chun ◽  
Chad G. Ball ◽  
Andrew. W. Kirkpatrick
Keyword(s):  
Compartment Syndrome ◽  
Critically Ill ◽  
Abdominal Compartment Syndrome ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Young Male ◽  
Care Providers ◽  
Anoxic Injury ◽  
Life Saving ◽  
Abdominal Compartment

Extracorporeal life support (ECLS) is an incredible life-saving measure that is being used ever more frequently in the care of the critically ill. Management of these patients requires extreme vigilance on the part of the care providers in recognizing and addressing the complications and challenges that may arise. We present a case of overt abdominal compartment syndrome (ACS) in a previously well young male on ECLS with a history of trauma, submersion, hypothermia, and no intra-abdominal injuries. The patient developed ACS soon after ECLS was initiated which resulted in drastically compromised flow rates. Taking into account the patient’s critical status, an emergent laparotomy was performed in the intensive care unit which successfully resolved the ACS and restored ECLS flow. The patient had an unremarkable course following and was weaned off ECLS but unfortunately died from his original anoxic injury. This case highlights several salient points: first, care of patients on ECLS is challenging and multiple etiologies can affect our ability to manage these patients; second, intra-abdominal pressures should be monitored liberally in the critically ill, especially in patients on ECLS; third, protocols for emergent operative treatment outside of traditional operating rooms should be established and care providers should be prepared for these situations.

Acute Abdominal Compartment Syndrome in the Critically Ill

1999 ◽  
Vol 14 (5) ◽  
pp. 207-219
Author(s):  
Bob H. Saggi ◽  
Harvey J. Sugerman ◽  
Rao R. Ivatury ◽  
Geoffrey L. Bloomfield
Keyword(s):  
Compartment Syndrome ◽  
Critically Ill ◽  
Abdominal Compartment Syndrome ◽  
Abdominal Compartment

Subcutaneous Linea Alba Fasciotomy: A Less Morbid Treatment for Abdominal Compartment Syndrome

2008 ◽  
Vol 74 (8) ◽  
pp. 746-749 ◽  
Author(s):  
Michael L. Cheatham ◽  
Jessica Fowler ◽  
Peter Pappas
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Injured Patient ◽  
Abdominal Pressure ◽  
Linea Alba ◽  
Medical Interventions ◽  
Enteroatmospheric Fistula ◽  
Abdominal Decompression ◽  
Abdominal Compartment ◽  
New Surgical Technique

Abdominal compartment syndrome is a cause of significant morbidity and mortality among surgical patients. It has traditionally been treated by abdominal decompression with the associated risks of chronic incisional hernia and enteroatmospheric fistula. Subcutaneous linea alba fasciotomy has recently been described as a new surgical technique for the treatment of abdominal compartment syndrome secondary to acute pancreatitis. This technique reduces intra-abdominal pressure and restores organ function while maintaining the skin and peritoneum intact for visceral protection. We describe the application of subcutaneous linea alba fasciotomy as a safe and effective alternative for the surgical management of abdominal compartment syndrome in a traumatically injured patient refractory to comprehensive medical interventions.

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