Chest
Original ResearchCritical CarePercutaneous Catheter Decompression in the Treatment of Elevated Intraabdominal Pressure
Section snippets
Materials and Methods
Since January 2002, we have performed an ongoing, prospective, observational study to confirm the survival efficacy of our evidence-based medicine approach to the management of patients with IAH/ACS. This study was approved by the Orlando Health Institutional Review Board (09.068.04) with a waiver of informed consent. All patients aged ≥ 15 years who are admitted to the surgical teaching service of our institution and require either PCD or OAD during their resuscitation and management are
Results
Between March 2007 and May 2010, 265 consecutive patients with IAH/ACS were managed using OAD in our institution. We retrospectively identified an additional 31 consecutive patients during the same time period who were managed with PCD. The patients receiving PCD were evenly distributed through the study period as follows: 2007, six patients; 2008, eight patients; 2009, 11 patients; and 2010, six patients. The demographics of the 31 patients receiving PCD and 31 disease and severity of
Discussion
The diagnosis and management of IAH/ACS has evolved significantly over the past 2 decades through improved recognition of the risk factors for elevated IAP as well as understanding of the therapeutic treatment options available. Earlier diagnosis allows the application of a variety of nonoperative therapies that have been demonstrated to significantly improve survival from IAH/ACS.1, 10,13, 14,18, 19 Patients who manifest elevations in IAP and organ dysfunction that are refractory to these
Acknowledgments
Author contributions: Dr Cheatham had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Cheatham: contributed to the study design, data collection, data analysis, and manuscript preparation.
Ms Safcsak: contributed to the study design, data collection, data analysis, and manuscript preparation.
Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr
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Intra-abdominal hypertension and abdominal compartment syndrome
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2021, Radiology Case ReportsCitation Excerpt :Additionally, those that did not drain at least 1 L of fluid or decrease abdominal pressure by at least 9 mmHg in the first 4 hours following decompression required subsequent laparotomy for definitive treatment [7]. Limited data has shown that there is reduced length of stay and improved survival to discharge when comparing percutaneous drainage and decompressive laparotomy [7,8]. With this study in mind, it is crucial to recognize that interventionalists play a vital role in catheter directed treatment of ACS.
Abdominal compartment syndrome: Current concepts and management
2020, Revista de Gastroenterologia de MexicoIntraabdominal hypertension/abdominal compartment syndrome after pelvic fractures: How they occur and what can be done?
2019, InjuryCitation Excerpt :There are a number of unresolved issues relating to IAH, in particular, which parameter should be the threshold for DL in patients with IAH. In our study, prophylactic DL was performed in patients with refractory IAH (sustained ≥ 24 h and/or unresponsive to nonoperative interventions and progression to the next grade of IAH) [14,15]. The rationale of this principle is that transient (approximately 24 h) IAH does not cause organ dysfunction; however, sustained IAH compromises visceral perfusion and causes organ dysfunction [14].
What is abdominal compartment syndrome and how should it be managed?
2019, Evidence-Based Practice of Critical Care
Funding/Support: The authors have reported to CHEST that no funding was received for this study.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).