Open abdomen during extracorporeal membrane oxygenation is a safe and effective treatment for abdominal compartment syndrome

Brown, Joshua W.; Warnock, Brielle; Turk, Eamaan; Hobson, Michael J.; Friedman, Matthew L; Gray, Brian W.

doi:10.1016/j.jpedsurg.2021.11.020

Cited by 5 publications

(6 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[4][5][6] However, both DL and percutaneous approaches have shown poor outcomes, as described in Table 1. 1,3,4,6,7 According to our knowledge, only one neonate in the literature survived DL during ECMO, but few details regarding outcomes were reported. 3 Our patient evolved favorably, without any diaphragmatic mesh infection, which was of particular concern given the open abdomen, and no neurologic or hematologic complication.…”

Section: Discussionmentioning

confidence: 99%

“…1,3,4,6,7 According to our knowledge, only one neonate in the literature survived DL during ECMO, but few details regarding outcomes were reported. 3 Our patient evolved favorably, without any diaphragmatic mesh infection, which was of particular concern given the open abdomen, and no neurologic or hematologic complication. Heparin anticoagulation was challenging and this probably contributed to the ACS.…”

Section: Discussionmentioning

confidence: 99%

“…2 The treatment of choice for ACS is decompressive laparotomy (DL), which is challenging during pediatric ECMO due to high bleeding risks and potential futility of the procedure. 1,3 In neonates, a single case has previously been described, with no other reported outcomes than survival to discharge. We hereby present the case of a neonate who underwent DL while on ECMO following CDH repair, with excellent outcomes, aiming to challenge the very poor reported outcomes of this procedure in young children.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Successful decompressive laparotomy in a neonate with abdominal compartment syndrome on extracorporeal membrane oxygenation following congenital diaphragmatic hernia repair

et al. 2022

View full text Add to dashboard Cite

Abdominal compartment syndrome (ACS) is a rare complication of extracorporeal membrane oxygenation (ECMO) and is associated with high morbidity and mortality. Despite being the treatment of choice for ACS, decompressive laparotomy (DL) has been a matter of debate in children supported with ECMO due to high bleeding risk and presumed futility. We report the first neonatal DL for ACS while on ECMO following congenital diaphragmatic hernia (CDH) repair. Given its excellent outcomes, our case challenges current literature and supports prompt bedside laparotomy to treat ACS on neonatal ECMO.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Successful decompressive laparotomy in a neonate with abdominal compartment syndrome on extracorporeal membrane oxygenation following congenital diaphragmatic hernia repair

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Brown et al [46] describe their experience with six paediatric patients requiring extracorporeal membrane oxygenation (ECMO) who developed ACS during treatment with ECMO. They were treated with decompressive laparotomy; survival was comparable to the 75 patients not requiring decompressive laparotomy, but patients after decompression had fewer ECMO complications.…”

Section: Conditions Commonly Associated With Intra-abdominal Hyperten...mentioning

confidence: 99%

“…Brown et al [46] describe their experience with six paediatric patients requiring extracorporeal membrane oxygenation (ECMO) who developed ACS during treatment with ECMO. They were…”

Section: Conditions Commonly Associated With Intra-abdominal Hyperten...mentioning

confidence: 99%

Intra-abdominal hypertension and abdominal compartment syndrome

Waele

2022

Current Opinion in Critical Care

View full text Add to dashboard Cite

Purpose of reviewIntra-abdominal hypertension (IAH) has been acknowledged as an important contributor to organ dysfunction in critically ill patients, both in surgical and medical conditions. As our understanding of the pathophysiology evolves, risk factors are better recognized, preventive measures can now be implemented and therapeutic interventions tailored to the physiology of the patient. In the current review, we want to highlight developing insights in the epidemiology and treatment of patients with IAH and ACS. Recent findingsThe impact of IAH and ACS on kidney function and other outcomes continues to draw attention in recent studies. New methods for IAP measurement are under development, and the search for biomarkers to detect IAH or ACS continues. In conditions wherein IAH and ACS are common, recent studies allow better prevention and treatment of these conditions, based on the contemporary ICU management consisting of IAP measurement, judicious fluid resuscitation and decompressive laparotomy where necessary. Surgical treatment options including open abdomen therapy continue to be improved with demonstrable impact on outcomes.

show abstract