Abdominal Compartment Syndrome

Deenichin, Georgi Petrov

doi:10.1007/s00595-007-3573-x

Cited by 42 publications

(57 citation statements)

References 60 publications

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“…The increase of Intra-Abdominal Pressure (IAP) in a patient with ACS decreases lung compliance and increases peak airway pressure during mechanical ventilation, resulting in hypoxemia and hypercapnia. It also decreases venous return, which reduces cardiac output and abdominal organ perfusion, causing oliguria and splanchnic ischemia [2,3]. Normal IAP is < 0 mmHg, and IAP > 20 mmHg is clinically significant.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Compartment Syndrome during Off-pump Coronary Artery Bypass: a Case Report

Lee¹

2016

SOJAPM

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We report a case of intraoperative hemodynamic instability due to abdominal compartment syndrome in a 65-year-old woman who underwent elective off-pump coronary artery bypass graft. She had manifestation of destabilized hemodynamic and respiration, and detected an extremely tense and distended abdomen when the sternum was closed. After excluding hemorrhage and right heart failure, the patient was considered to have ACS. Then a nasogastric tube was inserted to decompress the stomach and 100 ml of 20% mannitol was administered intravenously. With the above treatment, the patient was gradually relieved, and discharged 12 days later. Keywords:Abdominal compartment syndrome; Off-pump coronary artery bypass graft surgery Jeokgeum-ro, Danwon-gu, Ansan-si, Gyunggi-do, 15355, South Korea, Tel: +82-31-412-5316; Fax: +82-31-412-5294; E-mail: yslee4719@gmail.com dropped from 110/70 to 60/30 mmHg and heart rate increased from 80 to 130/min. At a tidal volume of 400 ml and a respiratory rate of l2/min, peak airway pressure concomitantly increased from 18 to 30 cm H 2 O, end tidal CO 2 increased from 29 to 33 mmHg, and SpO 2 in 50% oxygen/air mixture decreased to 96%. Lung sounds were equal and clear. Then, Mean Pulmonary Arterial Pressure (mPAP) increased from 18 to 28 mmHg, and central venous pressure (CVP) increased from 5 to 17 mmHg. Fluid was infused rapidly and inotropic support was provided, including dopamine, dobutamine, and phenylephrine. Phenylephrine (50 µg) was administered intravenously. Phenylephrine (100 µg) was then given repeatedly, which increased blood pressure only slightly to 90/50 mmHg. Dopamine and dobutamine were titrated to maintain systolic blood pressure > 90 mmHg. Blood pressure was maintained at 90-100/50-60 mmHg and heart rate was maintained at 110-130/min. Urinary output was maintained during the operation. An arterial blood gas analysis on 100% oxygen showed pH of 7.25, PaCO 2 of 45.1 mmHg, and PaO 2 of 124 mmHg. Tidal volume and respiratory rate were reset to improve the progressively worsening oxygenation and to increase peak inspiratory pressure. CVP and mPAP did not decrease during fluid resuscitation and inotropic support. Bleeding and right heart failure was suspected. The surgeons were informed that ventilation was becoming more difficult, but no cause for the problem was provided. Hemoglobin was 10.2 g/dl and platelet count was 55,000 cells/ µl. The patient had received about 2000 ml of intravenous crystalloid solution, five units of packed red blood cells, five units of fresh frozen plasma, and eight units of platelet concentrate.An extremely tense and distended abdomen was detected when the sternum was closed. A nasogastric tube was inserted to decompress the stomach and 100 ml of 20% mannitol was administered intravenously. Respiratory and the hemodynamic variables improved gradually 30 min later. Peak inspiratory pressure decreased to 25 cm H 2 O, blood pressure increased to 110/60 mmHg, and heart rate decreased 100/min. Ultrasonography revealed fluid in the abdominal c...

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Section: Discussionmentioning

confidence: 99%

Abdominal Compartment Syndrome during Off-pump Coronary Artery Bypass: a Case Report

Lee¹

2016

SOJAPM

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“…IAH and ACS are among the leading causes of death in critically ill surgical patients because of the difficulties involved in its diagnosis, incompletely understood pathophysiology, and a lack of successful therapy [2][3][4][5][6][7]. The rate of mortality in ACS has been reported to be approximately 40-70% [8]. ACS is associated with impairments such as renal failure, oliguria, cardiac shock, systemic hypotension, and pulmonary distress syndrome [4,[9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Beneficial effects of theophylline infusions in surgical patients with intra-abdominal hypertension

Bodnár

Szentkereszty

Hajdu

et al. 2011

Langenbecks Arch Surg

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Adenosine receptor antagonism with T following IAH diagnosis resulted in markedly reduced mortality in patients with moderated IAH (<20 mmHg). Theophylline-associated mortality reduction may be related to improved renal perfusion and improved MAP, presumably caused by adenosine receptor blockade. Because this study was not a randomized controlled study, these compelling observations require further multicentric clinical confirmation.

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“…[9,10] The optimum temporary closure technique should, therefore, provide these main goals without traumatizing intestinal organs.…”

Section: Original Articlementioning

confidence: 99%

Comparison of early surgical alternatives in the management of open abdomen: a randomized controlled study

Rencüzoğulları

Dalcı

Eray

et al. 2015

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Abdominal compartment syndrome (ACS) is a clinical syndrome characterized by progressive intraabdominal organ dysfunction resulting from an acute increase in intra-abdominal pressure (IAP). In the absence of prompt treatment, ACS can lead to lethal organ failure. Treatment of ACS is achieved by immediate decompression of the abdominal cavity. As to how and when decompression laparotomy should be performed depends on the clinical condition of the patients. There is limited data regarding outcomes of abdominal closure techiques. The present study aimed to investigate two different temporary closure methods, the vacuum assisted closure (VAC) and Bogota bag techniques, in 40 patients who underwent decompressive laparotomy as part of the management of ACS.

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Abdominal Compartment Syndrome

Cited by 42 publications

References 60 publications

Abdominal Compartment Syndrome during Off-pump Coronary Artery Bypass: a Case Report

Abdominal Compartment Syndrome during Off-pump Coronary Artery Bypass: a Case Report

Beneficial effects of theophylline infusions in surgical patients with intra-abdominal hypertension

Comparison of early surgical alternatives in the management of open abdomen: a randomized controlled study

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