A team from Denver, USA, characterized patients who develop secondary abdominal compartment syndrome (ACS).
Their prospective ACS database was reviewed for cases of secondary ACS.
Some 14 patients (13 male, mean age 45 years) were found to have developed ACS a mean of 11.6 hours following resuscitation from shock.
Of these, 11 (79%) had required vasopressors; the worst base deficit was 14.1.
|Mortality from secondary ACS:|
Trauma patients: 38%
| American Journal of Surgery |
Resuscitation included a mean of 16.7 liters of crystalloid and 13.3 red blood cell units.
The researchers found that decompressive laparotomy improved intra-abdominal, systolic, and peak airway pressures, as well as urine output.
However, mortality was found to be 38% among trauma and 100% among non-trauma patients.
Author W. L. Biffl, of the Denver Health Medical Center, said on behalf of the group, "General surgeons may encounter secondary ACS in a variety of clinical scenarios; resuscitation from severe shock appears to be the critical factor."
"Early identification and abdominal decompression are essential. Unfortunately, in our experience, this is a highly lethal event," it was concluded.