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Secondary abdominal compartment syndrome is a highly lethal event
W L Biffl1, E E Moore, J M Burch
1Department of Surgery, Box 0206, Denver Health Medical Center, 777 Bannock St., Denver, CO 80204-4507, USA. wbiffl@dhha.org
American Journal of Surgery
|February 13, 2002
Summary
Resuscitation can lead to secondary abdominal compartment syndrome (ACS) in trauma and non-trauma patients. Early recognition and decompression are crucial for survival in this highly lethal condition.
Area of Science:
- Critical Care Medicine
- Surgical Critical Care
- Abdominal Hypertension
Background:
- Secondary abdominal compartment syndrome (ACS) is increasingly reported in trauma patients post-resuscitation.
- This condition can also occur in non-trauma patients, necessitating a broader understanding.
Purpose of the Study:
- To characterize patients who develop secondary ACS.
- To identify risk factors and outcomes associated with secondary ACS.
Main Methods:
- Prospective review of a dedicated abdominal compartment syndrome database.
- Recording of physiological parameters and patient outcomes.
- Data analysis using mean +/- SEM for reporting.
Main Results:
- Fourteen patients (13 male, 45 +/- 5 years) developed secondary ACS 11.6 +/- 2.2 hours post-resuscitation.
- Patients required significant resuscitation (16.7 +/- 3.0 L crystalloid, 13.3 +/- 2.9 RBC units) and vasopressors.
- Decompressive laparotomy improved key physiological parameters, but mortality was high (38% trauma, 100% non-trauma).
Conclusions:
- Secondary ACS is a critical condition encountered in diverse clinical settings, primarily linked to resuscitation from severe shock.
- Early identification and prompt abdominal decompression are vital for patient management.
- Despite interventions, secondary ACS remains a highly lethal event with poor outcomes.