Ischemic bowel as a late sequela of abdominal compartment syndrome secondary to severe burn injury

Sun, Ken; Hancock, B.J.; Logsetty, Sarvesh

doi:10.1177/229255031502300407

Cited by 7 publications

(10 citation statements)

References 13 publications

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“…The huge impact of an increased intraabdominal pressure can be seen in the impaired functions of multiple organs such as the lungs, bowel, and the kidneys. That is why immediate diagnosis and appropriate intervention is of vital concern (8,9,(12)(13)(14). This ranges from medical treatment of IAH to surgical treatment when the patient's condition aggravates or ACS develops (14).…”

Section: Discussionmentioning

confidence: 99%

The Need for Emergency Laparotomy With Open Abdomen Therapy in the Course of ECMO—A Retrospective Analysis of Course and Outcome

et al. 2020

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Background: Abdominal compartment syndrome (ACS) can occur in patients placed on extra corporeal membrane oxygenation (ECMO). This implies the necessity of decompressive laparotomy followed by an open abdomen (OA) to prevent complications such as multi-organ-failure or death. Methods: We searched for ECMO patients in our hospital database between July 2015 and April 2020 and selected those with an emergency laparotomy and OA therapy. Of these, we analyzed only patients who were treated with an OA after establishing the ECMO regarding patient-related parameters like sex, age, height, weight, and indications for ECMO as well as outcome parameters like complete fascial closure rate, mortality, length of stay in intensive care unit (ICU), length and kind of OA therapy, number of surgical procedures, dressing changes concerning negative pressure wound therapy (NPWT), and number of surgical revisions. Results: In eight out of 421 patients (1.9%), a laparostoma had to be created during ECMO support. For temporary closure, either NPWT, abdominal packing, or both were used. The median length of OA therapy was 17 days, and the median length of stay in ICU was 42 days in total. The median number of surgical procedures and NPWT dressing changes was seven. In three of the eight patients, a surgical revision was necessary. The total mortality rate was 50%. In 75%, the fascia could be closed. Two patients died before final closure. In all deceased patients, an abdominal packing was necessary during the course of treatment; in the survivors, only once. No enteroatmospheric fistula or abscesses occurred. Conclusions: ACS in patients placed on ECMO is a very rare condition with a considerable mortality rate but high secondary closure rate of the fascia. A necessary abdominal packing due to a severe bleeding seems to be a risk factor with a potentially fatal outcome.

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Section: Discussionmentioning

confidence: 99%

The Need for Emergency Laparotomy With Open Abdomen Therapy in the Course of ECMO—A Retrospective Analysis of Course and Outcome

et al. 2020

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“…Children are more susceptible to the development of abdominal compartment syndrome in part due to their relatively smaller abdominal cavity (84). Abdominal compartment syndrome is associated with increased mortality (82). If nonsurgical treatments fail, definitive treatment of abdominal compartment syndrome is laparotomy, in which a functional fascial release allows decompression.…”

Section: Abdominal Compartment Syndromementioning

confidence: 99%

“…Renal perfusion is decreased, which lowers urine output; similarly, mesenteric flow is decreased (81,82). Systemic inflammation during this time also can exacerbate injury (82).…”

Section: Abdominal Compartment Syndromementioning

confidence: 99%

Variables Influencing the Differential Host Response to Burns in Pediatric and Adult Patients

Barrios

Polcz

Moldawer

et al. 2022

Shock

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Burn injury is a significant source of morbidity and mortality in the pediatric population. Although 40,000 pediatric patients in the United States are admitted to the hospital with burn wounds annually, significant differences exist in the management and treatment of these patients, even among highly specialized burn centers. Some aspects of pediatric burn research, such as metabolic changes and nutritional support after burn injury, have been studied extensively; however, in many aspects of burn care, pediatric research lags behind the study of adult populations. This review compares and contrasts a wide array of physiologic and immune responses between children and adults after burn injury. Such a review elucidates where robust research has been conducted, where adult research is applicable to pediatric patients, and where additional pediatric burn research needs to be conducted.

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“…ВБД, а брюшная (A.celiaca) и верхняя брыжеечная артерии скомпрометированы при ВБД > 40 мм рт.ст. Кроме снижения желудочной циркуляци ВБГ вызывает компрессию брыжеечных вен, ухудшая венозный отток крови, что в конечном итоге приводит к дальнейшей гипоперфузии кишечника, ишемическому кишечнику, уменьшению интрамурального рН и ухудшению лактоацидоза [5][6][7][8]. В контексте повреждения ткани, соответствующего тяжелой ожоговой травме, воспалительные реакции могут также усугубить ишемический кишечник.…”

Section: науковий оглядunclassified

Профилактика И Лечение Абдоминального Компартмент-Синдрома У Больных С Тяжелой Термической Травмой

Oliynyk¹,

Lytovchenko²,

Lytovchenko³

2021

ЕМ

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Профилактика и лечение абдоминального компартмент-синдрома у больных с тяжелой термической травмой Резюме. Внутрибрюшная гипертензия и абдоминальный компартмент-синдром тесно связаны с заболеваемостью и смертностью среди критически больных. Несмотря на достаточно большое количество специальных публикаций, посвященных данной проблеме, очень мало внимания уделяется абдоминальному компартмент-синдрому у больных с тяжелой термической травмой. В ряде исследований показано, что тяжелые ожоги являются фактором риска развития внутрибрюшной гипертензии. Большие объемы инфузионной терапии, используемые при лечении тяжелой ожоговой травмы, дополнительно предрасполагают пациентов к увеличению внутрибрюшного давления. Частота развития внутрибрюшной гипертензии у больных с тяжелой термической травмой составляет, по данным разных авторов, 57,8-82,6 %. После возникновения абдоминального компартмент-синдрома и связанной с ним полиорганной дисфункции летальность при обширных ожогах очень высока. Цель данной работы-проанализировать проблему развития абдоминальной гипертензии и абдоминального компартмент-синдрома у ожоговых больных, а также сделать выводы о профилактике данного состояния и улучшении результатов лечения пострадавших с тяжелой термической травмой.

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Ischemic bowel as a late sequela of abdominal compartment syndrome secondary to severe burn injury

Cited by 7 publications

References 13 publications

The Need for Emergency Laparotomy With Open Abdomen Therapy in the Course of ECMO—A Retrospective Analysis of Course and Outcome

The Need for Emergency Laparotomy With Open Abdomen Therapy in the Course of ECMO—A Retrospective Analysis of Course and Outcome

Variables Influencing the Differential Host Response to Burns in Pediatric and Adult Patients

Профилактика И Лечение Абдоминального Компартмент-Синдрома У Больных С Тяжелой Термической Травмой

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