Document Detail


The abdominal compartment syndrome is a morbid complication of postinjury damage control surgery.
MedLine Citation:
PMID:  11839314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The abdominal compartment syndrome (ACS) is a recognized complication of damage control surgery (DCS). The purposes of this study were to (1) determine the effect of ACS on outcome after DCS, (2) identify patients at high risk for the development of ACS, and (3) determine whether ACS can be prevented by preemptive intravenous bag closure during DCS. METHODS: Patients requiring postinjury DCS at our institution from January 1996 to June 2000 were divided into groups depending on whether or not they developed ACS. ACS was defined as an intra-abdominal pressure (IAP) greater than 20 mm Hg in association with increased airway pressure or impaired renal function. RESULTS: ACS developed in 36% of the 77 patients who underwent DCS with a mean IAP prior to decompression of 26 +/- 1 mm Hg. The ACS versus non-ACS groups were not significantly different in patient demographics, Injury Severity Score, emergency department vital signs, or intensive care unit admission indices (blood pressure, temperature, base deficit, cardiac index, lactate, international normalized ratio, partial thromboplastin time, and 24-hour fluid). The initial peak airway pressure after DCS was higher in those patients who went on to develop ACS. The development of ACS after DCS was associated with increased ICU stays, days of ventilation, complications, multiorgan failure, and mortality. CONCLUSIONS: ACS after postinjury DCS worsens outcome. With the exception of early elevation in peak airway pressure, we could not identify patients at higher risk for ACS; moreover, preemptive abdominal bag closure during initial DCS did not prevent this highly morbid complication.
Authors:
C D Raeburn; E E Moore; W L Biffl; J L Johnson; D R Meldrum; P J Offner; R J Franciose; J M Burch
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of surgery     Volume:  182     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2002-02-12     Completed Date:  2002-03-21     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  542-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Denver Health Medical Center and University of Colorado Health Sciences Center, 777 Bannock, Unit 1, Denver, CO 80204, USA.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / blood supply*
Adolescent
Adult
Aged
Compartment Syndromes / etiology*,  physiopathology
Emergencies
Female
Humans
Male
Middle Aged
Multiple Trauma / surgery*
Postoperative Complications
Pressure
Grant Support
ID/Acronym/Agency:
P50 GM049222-09/GM/NIGMS NIH HHS; T32 GM08315-10/GM/NIGMS NIH HHS
Comments/Corrections
Comment In:
Am J Surg. 2002 Dec;184(6):658; author reply 658-60   [PMID:  12488208 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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