Supranormal Trauma Resuscitation Causes More Cases of Abdominal Compartment Syndrome

Balogh, Zsolt J.

doi:10.1001/archsurg.138.6.637

Cited by 448 publications

(242 citation statements)

References 28 publications

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“…We enrolled 77 patients (24 women, 53 men) with a mean age of 62.6±16 years (range, 23-97), mean BMI of 24.6±3.9 (range, 18-34) kg/m 2 , mean operation time of 249±109 (range, 35-570) minutes, mean APACHE II score of 9.88±3.25 (range, [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Table 1 shows the distribution of patients according to type of surgery.…”

Section: Resultsmentioning

confidence: 99%

“…Any enlargement of internal organs due to edema as well as accumulation of ascites/blood or bowel distension increase IAP after abdominal surgery. Visceral edema due to massive fluid infusion is well known in trauma patients (5,7,8). Moreover, in a mixed population critically ill patients Malbrain et al showed that fluid resuscitation >3.5 L was the independent predictor of IAH (2).…”

Section: Discussionmentioning

confidence: 99%

“…Many risk factors for the development of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have been identified in critically ill patients (6). However, several authors have found 24-hour fluid balance and massive fluid resuscitation as well as abdominal surgery to be the independent predictors for the development of IAH (2,3,7,8).…”

Section: Introductionmentioning

confidence: 99%

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The influence of fluid balance on intra-abdominal pressure after major abdominal surgery

Šerpytis

Ivaškevičius

2008

Medicina

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The influence of fluid balance on intra-abdominal pressure after major abdominal surgery

Šerpytis

Ivaškevičius

2008

Medicina

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“…To avoid infusing excessive amounts of IV solutions and its complications, the condition of responsiveness to volume must be identified [50,[118][119][120]. The filling heart pressures have been used traditionally to accomplish this task, being that the pulmonary artery wedge pressure is considered as the standard.…”

Section: The Hypotense or Hypoperfused Trauma Patient In The Icumentioning

confidence: 99%

Critical Care Issues in the Early Management of Severe Trauma

García

2006

Surgical Clinics of North America

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Violent trauma and road traffic injuries kill more than 2.5 million people in the world every year. It has been calculated by the World Health Organization that in 2002 there occurred 1.6 million violent deaths [1] and 1.2 million deaths from traffic injury [2], for a combined mortality of 48 deaths per 100,000 population per year.Most trauma deaths occur at the scene or in the first hour after trauma, with a proportion from 34% to 50% occurring in hospitals [3]. These deaths could be prevented by optimization of trauma care. Preventability of trauma deaths has been reported as high as 76% [4] and as low as 1% in mature trauma systems [5,6].Prehospitalization procedures, elapsed time to hospital arrival are, of course, vital to the whole trauma scenario, but errors made in the in-hospital phase of care are responsible for one third to two thirds of the reported by different authors [7,8]. Of these, intensive care unit (ICU) errors are among the most frequent and significant. Errors in the ICU management of trauma patients were studied by Duke and colleagues [9]. They reported 165 ICU trauma deaths. Two hundred fifty-eight errors occurred in 81 patients (52%), and 134 of them contributed to death in 52 patients (34%). ICU errors were classified as management errors (82%), diagnostic (9%), technique (5%), and system inadequacies (4%). Davis and colleagues [10] identified critical care errors in 30% of 125 trauma deaths with errors. These errors contributed to 48% of all preventable deaths.The most common critical care errors are related to airway and respiratory management, fluid resuscitation, neurotrauma diagnosis and support, and delayed diagnosis of critical lesions [9,10].It is imperative for the general surgeon who takes care of trauma patients to know how to deal with these critical aspects, to reduce preventable morbidity and mortality. In the next segment, the situations in which the participation of the surgeon is crucial, during the initial phases of reanimation and stabilization of the critically traumatized patient will be discussed. Airway and ventilation managementAirway and respiratory management errors are the most common of those identified by several authors [9][10][11] The cardinal manifestation is a sudden or a rapidly progressing desaturation, frequently accompanied by tachycardia and arrhytmias, and occasionally by agitation. Hypertension announces the cardiovascular collapse, and bradicardia appears immediately after the total collapse [12]. The symptoms should not be attributed to agitation when it is present, and other possible causes must be ruled out before. Diagnosing the complication involves a directed physical examination, the analysis of the airway pressures and ventilator volumes, chest radiographs, and sometimes the measurement of arterial blood gases (ABG), and the urinary bladder pressure ( Table 1).The emergency conditions in which the access to the airways must be gained, the displacement to diagnosis areas or operating room and the agitation, often present, make the critical...

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“…Estudios recientes han demostrado que balances hídricos positivos persistentes se correlacionan con más intensa disfunción multiorgánica y con peor pronóstico 2,[61][62][63][64][65][66][67] . Esto ha sido demostrado para pacientes críticos en general 63 : sépticos 2,67 , traumatizados 68 , quemados 64 y con síndrome de distress respiratorio agudo 61,62,65 . Así también, balances hídricos positivos se asocian al desarrollo de hipertensión intraabdominal y síndrome compartimental del abdomen 68 .…”

Section: Efectos Deletéreos De La Hiper-reanimaciónunclassified