Patients with impending abdominal compartment syndrome do not respond to early volume loading

It is recommended that patients with impending abdominal compartment syndrome (ACS) should be volume loaded to insure the adequate preload. We evaluated our prospective resuscitation database to determine how patients who developed ACS differ from non-ACS patients in response to early volume loading...

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Bibliographic Details
Published in:The American journal of surgery 2003-12, Vol.186 (6), p.602-608
Main Authors: Balogh, Zsolt, McKinley, Bruce A, Cocanour, Christine S, Kozar, Rosemary A, Cox, Charles S, Moore, Frederick A
Format: Article
Language:English
Subjects:
Abdomen
Abdominal compartment syndrome
Acid-Base Imbalance
Adult
Age
Blood
Blood pressure
Blood Transfusion
Brain damage
Compartment Syndromes - blood
Compartment Syndromes - etiology
Compartment Syndromes - physiopathology
Compartment Syndromes - therapy
Crystalloid Solutions
Female
Hemodynamics
Hemoglobins - analysis
Hospitals
Humans
Hypertension
Injuries
Intensive care
Intraabdominal hypertension
Isotonic Solutions
Lactic Acid - blood
Lower Body Negative Pressure
Male
Mortality
Plasma Substitutes - administration & dosage
Plasma Substitutes - adverse effects
Prospective Studies
Pulmonary arteries
Resuscitation
Shock, Traumatic - blood
Shock, Traumatic - physiopathology
Shock, Traumatic - therapy
Studies
Trauma
Trauma centers
Traumatic shock resuscitation
Variables
Volume loading
Wounds and Injuries - complications
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Summary:It is recommended that patients with impending abdominal compartment syndrome (ACS) should be volume loaded to insure the adequate preload. We evaluated our prospective resuscitation database to determine how patients who developed ACS differ from non-ACS patients in response to early volume loading. Over 36 months, 152 consecutive high-risk patients were resuscitated by a standard intensive care unit (ICU) protocol that escalates interventions in nonresponders. Interventions, responses, and outcomes are prospectively collected and the characteristics of ACS and non-ACS patients were compared. Twenty-three patients (15%) developed ACS and were decompressed 8 ± 1 hours after ICU admission. The ACS and non-ACS patients had similar demographics and injury severity. The severity of pre-ICU shock tended to be greater in the ACS patients. During the first 8 hours of ICU resuscitation, patients who developed ACS received more blood transfusions (11 ± 2 versus 2 ± 0.2 units; P
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2003.09.002