Intra-abdominal Pressure Changes During Hip Arthroscopy: A Prospective Multicenter Study

Clinical Issues — March 2023

“…Complications involving fluid overload resulting from fluid extravasation or intravasation during minimally invasive procedures that use fluid distension media are rare but can be serious. Fluid extravasation occurs when fluid moves into the tissues and can lead to edema, 1,2 airway compromise, 1,2 abdominal distension, 3 and compartment syndromes near the operative site 3 . Fluid intravasation occurs when fluid is absorbed into the vasculature through vessels that are disrupted during resection of tissue and can lead to hyponatremia; 2,4 hypervolemia; 5 and cardiovascular, pulmonary, or neurological complications 1,4,5 .…”

“…Fluid intravasation occurs when fluid is absorbed into the vasculature through vessels that are disrupted during resection of tissue and can lead to hyponatremia; 2,4 hypervolemia; 5 and cardiovascular, pulmonary, or neurological complications 1,4,5 . Several studies have reported instances of airway compromise with shoulder arthroscopy and intra‐abdominal compartment syndrome after hip arthroscopy that were associated with extravasated fluid that had moved into the tissues 1,3,6,7 . Complications related to fluid distension media occur in less than 1% of operative or other invasive procedures, but the risk increases as the length of the procedure and the degree of tissue dissection increase 7,8 …”

Calculating Intraoperative Fluid Deficit to Prevent Abdominal Compartment Syndrome in Hip Arthroscopy

“…[10][11][12] Left untreated, this can lead to abdominal compartment syndrome (ACS), cardiac arrest, hypothermia, organ failure, and death. [3][4][5][6][7]13 ACS, defined as increased intraarterial pressure above 20 mm Hg, can result in acute organ dysfunction. 12 Early detection and management of IAH and ACS has shown to result improvement in organ function, reduced patients' postoperative pain levels, and increased patient survival.…”