PMID: 9168773Jun 1, 1997Paper

Abdominal compartment syndrome: case reports and implications for management in critically ill patients

The American Surgeon
M Williams, H H Simms

Abstract

Five cases are reviewed in which intra-abdominal pressures were used to decide whether critically ill patients would undergo exploratory laparotomy. This is a retrospective case series of a convenience sample of five critically ill, postoperative patients with a variety of underlying illnesses admitted to a surgical intensive care unit in a university hospital. Intra-abdominal compartment pressures were measured using the indirect method of urinary bladder pressure. In patients with signs of abdominal compartment syndrome, intra-abdominal pressures were measured. The pressures were measured every 6 hours until the signs had resolved or the patient was taken for exploratory laparotomy. All patients had Foley catheters. The drainage tubing to the catheters was clamped after the infusion of 200 cc of sterile water. An 18-gauge needle was inserted into the sampling port of the drainage tubing proximal to the clamp, and the needle was connected to a pressure transducer. An elevated abdominal compartment pressure was considered at greater than 25 mm Hg. The case series were reviewed to determine in critically ill patients whether intra-abdominal pressures could assist in deciding which patients required emergent exploratory laparotom...Continue Reading

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