2003, Number 5
PDF size: 54.89 Kb.
ABSTRACTIntroduction: Abdominal compartment syndrome (ACS) is an entity that represents a latent problem in the patient subjected to laparotomy.
Objective: To evaluate the effectiveness of decompressive treatment of ACS. Material and methods: We studied patients subjected to descompressive treatment for diagnosis of SCA from May 1 to November 30, 2001 prospectively. We evaluated intraabdominal pressure (IAP), peak pressure of air way (J)PVA), oxygen available index (OAi), ventilation-perfussion index and uresis, before, after, and at 48 h of decompressive surgery. The data were treated statistically with paired student t test taking as significant p<0.05 using percentages for qualitative variables and average with standard deviation for quantitative variables.
Results: We included 10 patients; three died (30%). Alone it VP& it descended significantly after compression (1><0.05). Uresis, PPVA, OlA and VPI were carried out 48 h of decompressive surgery.
Conclusions: is effective in ACS, showing immnediate decreased of IAP and improvement of the hemodynamic variables after 48 h post-surgery.
Burch JM, Moore EE, Moore FA, Franciose R. The Abdominal compartment syndrome. Surg Clin North Am 1996;76(4):841-851.
Ivatury KK, Diebel L, Porter JM, Simon RJ. Intra-abdominal hypertension and abdominal compartment syndrome. Surg Clin North Am 1997;77(4):779-795.
Saggi BH, Sugerman HJ, lvatury RR. Abdominal compartinent syndrome. J Trauma 1998;45(3):597-607.
Schein M, Wittman DH, Aprahamian CC, et al. The abdominal compartment syndrome: The physiological and clinical consequences of elevated intra-abdominal pressure. J Am Coll Surg 1995;180:745-753.
Fulda GJ, Stickles-Fulda E. Physiologic changes and outcome following surgical descompression for increased intra-abdominal pressure. Crit Care Med 1994;22:A68.
Edd V, Nunn C, Morris JA. Abdominal compartment syndrome. Surg Clin North Am 1997;77(4):797-807.
Schein M, Wittmann D. The Abdominal Compartment Syndrome Following Peritonitis, Abdominal Trauma, and Operations. Compl Surg 1996;15(5):756-762.
Ertel W, Overholzer A, Platz A, et al. Incidence and Clinical Pattern of the Abdominal Compartment Syndrome after “Damage Control” Laparotomy in 311 Patients with Severe Abdominal and/or Pelvic Trauma. Crit Care Med 2000;28(6):1747-1753.
Pusajo JF, Bumaschny E, Egurrola A. Postoperative intra-abdominal pressure: Its relation to splachnic perfusion, sepsis, multiple organ failure and surgical reintervention. Int Crit Care Dig 1994;13:2.
Iberti TJ, Kelly KM, Gentili DR. A simple technique to accurately determine intra-abdominal pressure. Crit Care Med 1987;15:11-40.
Hirshberg A, Mattox K, Ferrada R. Control de daños en cirugía de trauma. En: Rodríguez A, Ferrada R. Trauma. Sociedad Panamericana de Trauma. Colombia 1997;541-550.
Richards WO, Scovill W, SHin B, et al. Acute renal failure associated with increased intra-abdominal pressure. Ann Surg 1983;197:183-187.
Kron IL, Harman PK, Nolan SP. The measurement of intra-abdominal pressure as a criterio for abdominal re-exploration. Ann Surg 1984;199:28-30.
Obeid F, Saba A, Fath J, et al. Increases in intra-abdominal pressure effect pulmonary compliance. Arch Surg 1995;130:544-548.
Meldrum DR, Moore FA, Moore EE, et al. Prospective Characterization and selective management of the abdominal compartment syndrome. Am J Surg 1997;174:667-673.
Mayberry JC, Mullins RJ, Crass RA, et al. Prevention of Abdominal Compartment Syndrome by Absorbable Mesh Prosthesis Closure. Arch Surg 1997;132(9):957-962.
Sugrue M, Jones F, Janjua KJ, et al. Temporary abdominal closure: A prospective evaluation of us effects on renal and respiratory physiology. J Trauma 1998;45(5):914-921.
Ridings PC, Bloomfield GL, Blocher CK. Cardiopulmonary effects of raised intra-abdominal pressure before and after intravascular volume expansion. J Trauma 1995:39:1071-1075.
Shelley MP, Robinson AA, Hesford JW. Hemodynamic effects following surgical release of increased intra-abdominal pressure. J Surg Res 1981;59:800-805.