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Abdominal decompression for abdominal compartment syndrome in critically ill patients: a retrospective study

Jan De Waele (UGent) , Liesbeth Desender (UGent) , Inneke De laet (UGent) , Wim Ceelen (UGent) , Piet Pattyn (UGent) and Eric Hoste (UGent)
(2010) ACTA CLINICA BELGICA. 65(6). p.399-403
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Organization
Abstract
Background. The abdominal compartment syndrome (ACS) refers to organ dysfunction that may occur as a result of increased intra-abdominal pressure (IAP). Successful management may require abdominal decompression and temporary abdominal closure (TAC). The aim of this study was to analyze the characteristics of patients requiring abdominal decompression, to describe the methods used for TAC, and to study the outcome of these patients. Methods. A series of critically ill patients who required abdominal decompression for ACS between January 2000 and March 2007 were reviewed retrospectively. Age, gender, severity of organ dysfunction before decompression and the cause of ACS as well as the type of abdominal closure system and length of ICU-stay were recorded. Definitive abdominal closure and in-hospital mortality were the main outcome parameters. Results. Eighteen patients with primary ACS and 6 with secondary ACS required decompressive laparotomy. Patients ages ranged from 18 to 89 years (mean 50.7). The median preoperative IAP was 26mmHg, and IAP decreased to 13mmHg after decompressive laparotomy. Organ function, as quantified by the SOFA scoring system, improved significantly after the intervention. Eight patients had immediate primary fascial closure after the decompressive procedure and 16 patients required TAC. The majority of the survivors underwent planned ventral hernia repair at a later stage. The mean length of stay in the ICU was 23 (+/- 16) days. Overall, fifteen patients survived (63%). Conclusions. Decompressive laparotomy was effective in reducing IAP and was associated with an improvement in organ function. In most of the patients, the abdomen could not be closed after decompression, and fascial repair was delayed.
Keywords
INTERNATIONAL-CONFERENCE, CLOSURE, EXPERTS, OPEN ABDOMEN, intra-abdominal pressure, INTRAABDOMINAL HYPERTENSION, abdominal compartment syndrome

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Chicago
De Waele, Jan, Liesbeth Desender, De laetInneke, Wim Ceelen, Piet Pattyn, and Eric Hoste. 2010. “Abdominal Decompression for Abdominal Compartment Syndrome in Critically Ill Patients: a Retrospective Study.” Acta Clinica Belgica 65 (6): 399–403.
APA
De Waele, Jan, Desender, L., De laetInneke, Ceelen, W., Pattyn, P., & Hoste, E. (2010). Abdominal decompression for abdominal compartment syndrome in critically ill patients: a retrospective study. ACTA CLINICA BELGICA, 65(6), 399–403.
Vancouver
1.
De Waele J, Desender L, De laetInneke, Ceelen W, Pattyn P, Hoste E. Abdominal decompression for abdominal compartment syndrome in critically ill patients: a retrospective study. ACTA CLINICA BELGICA. 2010;65(6):399–403.
MLA
De Waele, Jan, Liesbeth Desender, De laetInneke, et al. “Abdominal Decompression for Abdominal Compartment Syndrome in Critically Ill Patients: a Retrospective Study.” ACTA CLINICA BELGICA 65.6 (2010): 399–403. Print.
@article{1112776,
  abstract     = {Background. The abdominal compartment syndrome (ACS) refers to organ dysfunction that may occur as a result of increased intra-abdominal pressure (IAP). Successful management may require abdominal decompression and temporary abdominal closure (TAC). The aim of this study was to analyze the characteristics of patients requiring abdominal decompression, to describe the methods used for TAC, and to study the outcome of these patients. Methods. A series of critically ill patients who required abdominal decompression for ACS between January 2000 and March 2007 were reviewed retrospectively. Age, gender, severity of organ dysfunction before decompression and the cause of ACS as well as the type of abdominal closure system and length of ICU-stay were recorded. Definitive abdominal closure and in-hospital mortality were the main outcome parameters. Results. Eighteen patients with primary ACS and 6 with secondary ACS required decompressive laparotomy. Patients ages ranged from 18 to 89 years (mean 50.7). The median preoperative IAP was 26mmHg, and IAP decreased to 13mmHg after decompressive laparotomy. Organ function, as quantified by the SOFA scoring system, improved significantly after the intervention. Eight patients had immediate primary fascial closure after the decompressive procedure and 16 patients required TAC. The majority of the survivors underwent planned ventral hernia repair at a later stage. The mean length of stay in the ICU was 23 (+/- 16) days. Overall, fifteen patients survived (63\%). Conclusions. Decompressive laparotomy was effective in reducing IAP and was associated with an improvement in organ function. In most of the patients, the abdomen could not be closed after decompression, and fascial repair was delayed.},
  author       = {De Waele, Jan and Desender, Liesbeth and De laet, Inneke and Ceelen, Wim and Pattyn, Piet and Hoste, Eric},
  issn         = {0001-5512},
  journal      = {ACTA CLINICA BELGICA},
  keyword      = {INTERNATIONAL-CONFERENCE,CLOSURE,EXPERTS,OPEN ABDOMEN,intra-abdominal pressure,INTRAABDOMINAL HYPERTENSION,abdominal compartment syndrome},
  language     = {eng},
  number       = {6},
  pages        = {399--403},
  title        = {Abdominal decompression for abdominal compartment syndrome in critically ill patients: a retrospective study},
  volume       = {65},
  year         = {2010},
}

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