Secondary abdominal compartment syndrome is a highly lethal event
Secondary abdominal compartment syndrome is a highly lethal event
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DOI：
10.1016/s0002-9610(01)00814-5
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发表时间：
2001-12-01
影响因子：
3
通讯作者：
Johnson, JL
中科院分区：
文献类型：
--
作者：
Biffl, WL;Moore, EE;Johnson, JL
背景资料：最近的报道描述了复苏诱导的，“继发性”腹腔室隔综合征（ACS）的创伤患者没有腹内损伤。我们已经在各种非创伤以及创伤患者中诊断出继发性ACS。本综述的目的是描述继发性ACS患者的特征。方法：回顾我们的前瞻性ACS数据库中继发性ACS的病例。记录生理参数和结局。数据表示为平均值± SEM。结果：14例患者（13例男性，年龄45 ± 5岁）在休克复苏后11.6 ± 2.2小时发生ACS。11人（79%）需要血管加压药;最严重的碱赤字为14.1 +/- 1.9。复苏包括16.7 +/- 3.0 L晶体和13.3 +/- 2.9红细胞单位。减压剖腹手术改善腹内，收缩压，气道峰压，以及尿量;然而，死亡率为38%之间的创伤和100%之间的非创伤patients.Conclusions：继发性ACS可能会遇到普通外科医生在各种临床情况下，复苏严重休克似乎是关键因素。早期识别和腹部减压是必不可少的。不幸的是，根据我们的经验，这是一个非常致命的事件。(C)2002年，Excerpta Medica，Inc. All rights reserved.
Background: Recent reports have described resuscitation-induced, "secondary" abdominal compartment syndrome (ACS) in trauma patients without intra-abdominal injuries. We have diagnosed secondary ACS in a variety of nontrauma as well as trauma patients. The purpose of this review is to characterize patients who develop secondary ACS.Methods: Our prospective ACS database was reviewed for cases of secondary ACS. Physiologic parameters and outcomes were recorded. Data are expressed as mean +/- SEM.Results: Fourteen patients (13 male, aged 45 +/- 5 years) developed ACS 11.6 +/- 2.2 hours following resuscitation from shock. Eleven (79%) had required vasopressors; the worst base deficit was 14.1 +/- 1.9. Resuscitation included 16.7 +/- 3.0 L crystalloid and 13.3 +/- 2.9 red blood cell units. Decompressive laparotomy improved intra-abdominal, systolic, and peak airway pressures, as well as urine output; however, mortality was 38% among trauma and 100% among nontrauma patients.Conclusions: Secondary ACS may be encountered by general surgeons in a variety of clinical scenarios; resuscitation from severe shock appears to be the critical factor. Early identification and abdominal decompression are essential. Unfortunately, in our experience, this is a highly lethal event. (C) 2002 Excerpta Medica, Inc. All rights reserved.