2003
DOI: 10.1007/s00268-003-6962-3
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Early Escharotomy as a Measure to Reduce Intraabdominal Hypertension in Full‐Thickness Burns of the Thoracic and Abdominal Area

Abstract: Intraabdominal hypertension (IAH) can occur in critically ill patients who have undergone surgery, who have required fluid resuscitation after intraabdominal operations, or whose abdominal surgical wound closure was under tension. If IAH remains unrelieved, it can lead to development of the abdominal compartment syndrome (ACS). The latter presents with severe cardiorespiratory and urinary symptoms such as hypotension, hypoventilation, and oliguria, and it can become fatal if it is not diagnosed early and treat… Show more

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Cited by 41 publications
(23 citation statements)
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“…• Umbilical hernia repair [145,146] • Muscle contractions (pain) [93] • Body builders (six-pack) [115] • Interstitial and anasarc oedema (skin, abdominal wall) • Abdominal burn eschars (circular) [97,98,147] • Thoracic burn eschars (circular) • Tight closure after abdominal surgery • Abdominal Velcro belt or adhesive drapes [148] • Prone positioning [103] • HOB > 45° [102] • Pneumoperitoneum • Pneumatic anti-shock garments • Abdominal wall bleeding • Rectus sheath haematoma [149] • Correction of large hernias • Gastroschisis • Omphalocoele • Mechanical ventilation (positive pressure) [65] • Fighting with the ventilator • Use of accessory muscles • Use of positive end expiratory pressure (PEEP) [66] • Presence of auto-PEEP (tension pneumothorax) • COPD emphysema (diaphragm flattening)…”
Section: Related To Abdominal Wall and Diaphragmmentioning
confidence: 99%
“…• Umbilical hernia repair [145,146] • Muscle contractions (pain) [93] • Body builders (six-pack) [115] • Interstitial and anasarc oedema (skin, abdominal wall) • Abdominal burn eschars (circular) [97,98,147] • Thoracic burn eschars (circular) • Tight closure after abdominal surgery • Abdominal Velcro belt or adhesive drapes [148] • Prone positioning [103] • HOB > 45° [102] • Pneumoperitoneum • Pneumatic anti-shock garments • Abdominal wall bleeding • Rectus sheath haematoma [149] • Correction of large hernias • Gastroschisis • Omphalocoele • Mechanical ventilation (positive pressure) [65] • Fighting with the ventilator • Use of accessory muscles • Use of positive end expiratory pressure (PEEP) [66] • Presence of auto-PEEP (tension pneumothorax) • COPD emphysema (diaphragm flattening)…”
Section: Related To Abdominal Wall and Diaphragmmentioning
confidence: 99%
“…Regarding ACS in burn patients, several case reports, 3,4,8,17 as well as reported of changes of physiologic parameters before and after decompression, 13,16 and a correlation between IAP and total fluid volume, 7,14 have been published. Deterioration of the ventilation status due to IAH was examined in both primary 2 and secondary ACS, 10 in which PIP, 5 PaO 2 , 16 PaCO 2 , 3 PaO 2 /F I O 2 ratio and pulmonary compliance 2 were evaluated.…”
Section: Discussionmentioning
confidence: 96%
“…Likewise, escharotomies (abdominal but also thoracic) will increase C ab while sternotomy will increase not only thoracic wall compliance but also C ab [42][43][44]. Placing a chest tube in case of a tension pneumothorax or pleural effusion will also increase C ab .…”
Section: Second Step: Remove Constrictive Bandages and Escharsmentioning
confidence: 99%