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

Jan De Waele UGent, Liesbeth Desender, Inneke De laet, Wim Ceelen UGent, Piet Pattyn UGent and Eric Hoste UGent (2010) ACTA CLINICA BELGICA. 65(6). p.399-403
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.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
INTERNATIONAL-CONFERENCE, CLOSURE, EXPERTS, OPEN ABDOMEN, intra-abdominal pressure, INTRAABDOMINAL HYPERTENSION, abdominal compartment syndrome
journal title
ACTA CLINICA BELGICA
Acta Clin. Belg.
volume
65
issue
6
pages
399 - 403
Web of Science type
Article
Web of Science id
000285739500005
JCR category
MEDICINE, GENERAL & INTERNAL
JCR impact factor
0.532 (2010)
JCR rank
104/151 (2010)
JCR quartile
3 (2010)
ISSN
0001-5512
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1112776
handle
http://hdl.handle.net/1854/LU-1112776
date created
2011-01-31 14:52:33
date last changed
2016-12-19 15:46:02
@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},
}

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.