Management of abdominal compartment syndrome in acute pancreatitis

Siebert, Matthieu; Fouler, Adrien Le; Sitbon, N.; Cohen, Jérémie F.; Abba, J.; Poupardin, Eric

doi:10.1016/j.jviscsurg.2021.01.001

Cited by 23 publications

(32 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some predictors may have gone unidentified due to missing data, such as intra-abdominal hypertension. However, several factors can influence intra-vesical pressure measurement [ 33 ] Another limitation is the lack of a standardized therapeutic algorithm, which may have induced bias via several mechanisms, such as the choice of one method over another. Also, the procedures and types of devices were at the discretion of the physicians, and operating-room availability may have led to one type of intervention being performed rather than another.…”

Section: Discussionmentioning

confidence: 99%

Infected pancreatic necrosis complicating severe acute pancreatitis in critically ill patients: predicting catheter drainage failure and need for necrosectomy

Garret

Douillard

David

et al. 2022

Ann. Intensive Care

View full text Add to dashboard Cite

Background Recent guidelines advocate a step-up approach for managing suspected infected pancreatic necrosis (IPN) during acute pancreatitis. Nearly half the patients require secondary necrosectomy after catheter drainage. Our primary objective was to assess the external validity of a previously reported nomogram for catheter drainage, based on four predictors of failure. Our secondary objectives were to identify other potential predictors of catheter-drainage failure. We retrospectively studied consecutive patients admitted to the intensive care units (ICUs) of three university hospitals in France between 2012 and 2016, for severe acute pancreatitis with suspected IPN requiring catheter drainage. We assessed drainage success and failure rates in 72 patients, with success defined as survival without subsequent necrosectomy and failure as death and/or subsequent necrosectomy required by inadequate improvement. We plotted the receiver operating characteristics (ROC) curve for the nomogram and computed the area under the curve (AUROC). Results Catheter drainage alone was successful in 32 (44.4%) patients. The nomogram predicted catheter-drainage failure with an AUROC of 0.71. By multivariate analysis, catheter-drainage failure was independently associated with a higher body mass index [odds ratio (OR), 1.12; 95% confidence interval (95% CI), 1.00–1.24; P = 0.048], heterogeneous collection (OR, 16.7; 95% CI, 1.83–152.46; P = 0.01), and respiratory failure onset within 24 h before catheter drainage (OR, 18.34; 95% CI, 2.18–154.3; P = 0.007). Conclusion Over half the patients required necrosectomy after failed catheter drainage. Newly identified predictors of catheter-drainage failure were heterogeneous collection and respiratory failure. Adding these predictors to the nomogram might help to identify patients at high risk of catheter-drainage failure. ClinicalTrials.gov number: NCT03234166.

show abstract

Section: Discussionmentioning

confidence: 99%

Infected pancreatic necrosis complicating severe acute pancreatitis in critically ill patients: predicting catheter drainage failure and need for necrosectomy

Garret

Douillard

David

et al. 2022

Ann. Intensive Care

View full text Add to dashboard Cite

show abstract

“…While commonly used guidelines by gastroenterological societies do not yet mention the benefit of routine IAP measurement [ 15 , 16 ], we follow other authors and the WSACS recommendations. Protocolized monitoring of IAP should routinely take place in high-risk patients such as those with severe acute pancreatitis, to allow for early detection and treatment of IAH and ACS [ 1 , 4 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Continuous Monitoring of Intra-abdominal Pressure in Severe Acute Pancreatitis Leads to Early Detection of Abdominal Compartment Syndrome: A Case Report

Akiode¹,

Moll²,

Schears³

2022

Cureus

View full text Add to dashboard Cite

Acute pancreatitis is a risk factor for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Immediate detection and management of IAH and ACS are critical for patient survival. Obtaining accurate and consistent intra-abdominal pressure and urinary output with high frequency is challenging, but critical for effective patient management. The presented case is of a 40-year-old man with a history of chronic alcoholism who developed severe acute pancreatitis. The patient was fluid resuscitated for distributive shock; hypoxic respiratory failure, intubation, and anuria followed. Real-time monitoring of urinary output and intra-abdominal pressure (IAP) allowed for early recognition of acute kidney injury (AKI) and ACS leading to early surgical intervention. Normalized IAP returned renal function and re-establishment of stable hemodynamics without vasopressors.

show abstract

“…The shortened laparotomy described for abdominal trauma is used in this surgical procedure. 19 Chiara stated that the best way to lower intra-abdominal pressure is by opening the abdomen, which is the preferred course of treatment for ACS when intra-abdominal pressure is consistently higher than 30 mmHg and continuous organ loss is resistant to medicinal therapy. The most common technique for surgical decompression is a vertical midline incision, however in some circumstances, bilateral subcostal incisions may be necessary.…”

Section: Treatment Of Acsmentioning

confidence: 99%

Intra-abdominal compartment syndrome: risk factors, complications and treatment

Almottowa

Nasser²,

Altamimi³

et al. 2022

Int J Community Med Public Health

View full text Add to dashboard Cite

An elevation in intra-abdominal pressure is the clinical condition referred as abdominal compartment syndrome (ACS). The prevalence varies depending on the patient characteristics considered, exponentially rising in life-threatening situations such as trauma, shock and burn patients. The syndrome can also occur after surgical operations like abdominal organ transplantation, post-transplant kidney syndrome among various others. All physiological systems, but particularly the cardiovascular, respiratory, renal, and neurological systems, are impacted by ACS. Blood flow to numerous organs is influenced by ACS and intra-abdominal hypertension. Recognizing and identifying ACS, its risk factors, and clinical symptoms can help to lower the associated morbidity and mortality. The purpose of this research is to review the available information about ACS: risk factors, complications and treatment. ACS is a fatal condition if not diagnosed and treated timely. Patients who have undergone extensive abdominal surgery, experienced septic issues, received intensive fluid replacement, sustained abdominal trauma are at an increased risk of developing ACS. Multiple-organ failure, prolonged recovery, acute kidney injury, low cardiac output, elevated cranial pressure and respiratory distress are the complications of ACS. ACS can occur regardless of the primary diagnosis or treating medical speciality. Surgical decompression, vascular volume replacement, prokinetic drugs, efficient curarization, and percutaneous drainage of large-volume ascites are the treatment strategies for ACS. Combining the underlying disease's therapy approach, patient stabilization, and ACS management is necessary to establish the best course of care. Early detection of ACS is essential for management and the treatment of the patients.

show abstract

Management of abdominal compartment syndrome in acute pancreatitis

Cited by 23 publications

References 50 publications

Infected pancreatic necrosis complicating severe acute pancreatitis in critically ill patients: predicting catheter drainage failure and need for necrosectomy

Infected pancreatic necrosis complicating severe acute pancreatitis in critically ill patients: predicting catheter drainage failure and need for necrosectomy

Continuous Monitoring of Intra-abdominal Pressure in Severe Acute Pancreatitis Leads to Early Detection of Abdominal Compartment Syndrome: A Case Report

Intra-abdominal compartment syndrome: risk factors, complications and treatment

Contact Info

Product

Resources

About