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A pilot study comparing percutaneous decompression with decompressive laparotomy for acute abdominal compartment syndrome in thermal injury
- Source :
- The Journal of burn carerehabilitation. 23(3)
- Publication Year :
- 2002
-
Abstract
- Abdominal Compartment Syndrome (ACS) has multiple causes, and decompressive laparotomy has been the most frequent modality to prevent worsening cardiovascular, respiratory, and renal function. This pilot study evaluated the utility of percutaneous drainage (PD) of peritoneal fluid compared with decompressive laparotomy in burn patients. A 26-month review was conducted. Nine of 13 (69%) study patients developed intra-abdominal hypertension (IAH) that progressed to abdominal compartment syndrome in 4 (31%). All were treated with PD using a diagnostic peritoneal lavage catheter. Peritoneal fluid analysis revealed a sterile plasma ultrafiltrate with electrolyte and other chemistries reflecting patient serum levels. Five patients underwent PD successfully, and their IAH did not progress to ACS. Four patients with greater than 80% TBSA and severe inhalation injury did not respond to PD and required decompressive laparotomy. There was no evidence of bowel edema, ischemia, or necrosis. All patients requiring decompressive laparotomies died either from sepsis or respiratory failure. Percutaneous decompression is a safe and effective method of decreasing IAH and preventing ACS in patients with less than 80% TBSA thermal injury.
- Subjects :
- Adult
medicine.medical_specialty
Percutaneous
Abdominal compartment syndrome
Adolescent
Body Surface Area
medicine.medical_treatment
Pilot Projects
Suction
Compartment Syndromes
Diagnostic peritoneal lavage
Catheters, Indwelling
Laparotomy
Abdomen
medicine
Ascitic Fluid
Humans
Child
General Nursing
Analysis of Variance
Chi-Square Distribution
medicine.diagnostic_test
business.industry
Peritoneal fluid
Rehabilitation
Middle Aged
medicine.disease
Decompression, Surgical
Surgery
Catheter
medicine.anatomical_structure
Treatment Outcome
Respiratory failure
Anesthesia
Child, Preschool
General Health Professions
Acute Disease
Emergency Medicine
Female
business
Burns
Subjects
Details
- ISSN :
- 02738481
- Volume :
- 23
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- The Journal of burn carerehabilitation
- Accession number :
- edsair.doi.dedup.....0f2d034a81fb4b860cd581bf500a0612