A pilot study comparing percutaneous decompression with decompressive laparotomy for acute Abdominal Compartment Syndrome in thermal injury
Abdominal Compartment Syndrome (ACS) has multiple causes, and decompressive laparotomy has been the most frequent modality to prevent worsening cardiovascular, respiratory, and renal function. This pilot study evaluated the utility of percutaneous drainage (PD) of peritoneal fluid compared with deco...
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| Veröffentlicht in: | Journal of burn care & rehabilitation 2002-05, Vol.23 (3), p.190-195 |
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| container_title | Journal of burn care & rehabilitation |
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| creator | LATENSER, Barbara A KOWAL-VERN, Areta KIMBALL, Douglas CHAKRIN, Alan DUJOVNY, Nadav |
| description | Abdominal Compartment Syndrome (ACS) has multiple causes, and decompressive laparotomy has been the most frequent modality to prevent worsening cardiovascular, respiratory, and renal function. This pilot study evaluated the utility of percutaneous drainage (PD) of peritoneal fluid compared with decompressive laparotomy in burn patients. A 26-month review was conducted. Nine of 13 (69%) study patients developed intra-abdominal hypertension (IAH) that progressed to abdominal compartment syndrome in 4 (31%). All were treated with PD using a diagnostic peritoneal lavage catheter. Peritoneal fluid analysis revealed a sterile plasma ultrafiltrate with electrolyte and other chemistries reflecting patient serum levels. Five patients underwent PD successfully, and their IAH did not progress to ACS. Four patients with greater than 80% TBSA and severe inhalation injury did not respond to PD and required decompressive laparotomy. There was no evidence of bowel edema, ischemia, or necrosis. All patients requiring decompressive laparotomies died either from sepsis or respiratory failure. Percutaneous decompression is a safe and effective method of decreasing IAH and preventing ACS in patients with less than 80% TBSA thermal injury. |
| doi_str_mv | 10.1097/00004630-200205000-00008 |
| format | Article |
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This pilot study evaluated the utility of percutaneous drainage (PD) of peritoneal fluid compared with decompressive laparotomy in burn patients. A 26-month review was conducted. Nine of 13 (69%) study patients developed intra-abdominal hypertension (IAH) that progressed to abdominal compartment syndrome in 4 (31%). All were treated with PD using a diagnostic peritoneal lavage catheter. Peritoneal fluid analysis revealed a sterile plasma ultrafiltrate with electrolyte and other chemistries reflecting patient serum levels. Five patients underwent PD successfully, and their IAH did not progress to ACS. Four patients with greater than 80% TBSA and severe inhalation injury did not respond to PD and required decompressive laparotomy. There was no evidence of bowel edema, ischemia, or necrosis. All patients requiring decompressive laparotomies died either from sepsis or respiratory failure. Percutaneous decompression is a safe and effective method of decreasing IAH and preventing ACS in patients with less than 80% TBSA thermal injury.</description><identifier>ISSN: 0273-8481</identifier><identifier>EISSN: 1534-5939</identifier><identifier>DOI: 10.1097/00004630-200205000-00008</identifier><identifier>PMID: 12032369</identifier><identifier>CODEN: JBCRD2</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Abdomen ; Abdomen - physiopathology ; Acute Disease ; Adolescent ; Adult ; Analysis of Variance ; Ascitic Fluid - metabolism ; Biological and medical sciences ; Body Surface Area ; Burns ; Burns - complications ; Burns - therapy ; Catheters, Indwelling ; Chi-Square Distribution ; Child ; Child, Preschool ; Compartment Syndromes - etiology ; Compartment Syndromes - surgery ; Compartment Syndromes - therapy ; Decompression, Surgical - methods ; Female ; Humans ; Laparotomy ; Medical sciences ; Middle Aged ; Pilot Projects ; Suction - methods ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Traumas. Diseases due to physical agents ; Treatment Outcome</subject><ispartof>Journal of burn care & rehabilitation, 2002-05, Vol.23 (3), p.190-195</ispartof><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c341t-a455a6b855e3831045ea62a628428b138a7353b0244fc5b22992102d3d10f6db3</citedby><cites>FETCH-LOGICAL-c341t-a455a6b855e3831045ea62a628428b138a7353b0244fc5b22992102d3d10f6db3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13673852$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12032369$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LATENSER, Barbara A</creatorcontrib><creatorcontrib>KOWAL-VERN, Areta</creatorcontrib><creatorcontrib>KIMBALL, Douglas</creatorcontrib><creatorcontrib>CHAKRIN, Alan</creatorcontrib><creatorcontrib>DUJOVNY, Nadav</creatorcontrib><title>A pilot study comparing percutaneous decompression with decompressive laparotomy for acute Abdominal Compartment Syndrome in thermal injury</title><title>Journal of burn care & rehabilitation</title><addtitle>J Burn Care Rehabil</addtitle><description>Abdominal Compartment Syndrome (ACS) has multiple causes, and decompressive laparotomy has been the most frequent modality to prevent worsening cardiovascular, respiratory, and renal function. This pilot study evaluated the utility of percutaneous drainage (PD) of peritoneal fluid compared with decompressive laparotomy in burn patients. A 26-month review was conducted. Nine of 13 (69%) study patients developed intra-abdominal hypertension (IAH) that progressed to abdominal compartment syndrome in 4 (31%). All were treated with PD using a diagnostic peritoneal lavage catheter. Peritoneal fluid analysis revealed a sterile plasma ultrafiltrate with electrolyte and other chemistries reflecting patient serum levels. Five patients underwent PD successfully, and their IAH did not progress to ACS. Four patients with greater than 80% TBSA and severe inhalation injury did not respond to PD and required decompressive laparotomy. There was no evidence of bowel edema, ischemia, or necrosis. All patients requiring decompressive laparotomies died either from sepsis or respiratory failure. Percutaneous decompression is a safe and effective method of decreasing IAH and preventing ACS in patients with less than 80% TBSA thermal injury.</description><subject>Abdomen</subject><subject>Abdomen - physiopathology</subject><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Analysis of Variance</subject><subject>Ascitic Fluid - metabolism</subject><subject>Biological and medical sciences</subject><subject>Body Surface Area</subject><subject>Burns</subject><subject>Burns - complications</subject><subject>Burns - therapy</subject><subject>Catheters, Indwelling</subject><subject>Chi-Square Distribution</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Compartment Syndromes - etiology</subject><subject>Compartment Syndromes - surgery</subject><subject>Compartment Syndromes - therapy</subject><subject>Decompression, Surgical - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Laparotomy</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pilot Projects</subject><subject>Suction - methods</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Treatment Outcome</subject><issn>0273-8481</issn><issn>1534-5939</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkd-O1CAUxolx4467voLhRu-qBw609HIy8V-yiRfuXje0pS6bAhWops_gS8vsjK6EhJzv_L5D4COEMnjHoG3eQ1miRqg4AAdZquooqWdkxySKSrbYPic74A1WSih2SV6m9ADA2qaWL8gl44Ac63ZHfu_pYueQacrruNEhuEVH67_TxcRhzdqbsCY6mmMjmpRs8PSXzff_Sz8NnXWxhRzcRqcQqS5WQ_f9GJz1eqaHx7HZGZ_pt82PMThDraf53kRX-tY_rHG7JheTnpN5dT6vyN3HD7eHz9XN109fDvubakDBcqWFlLrulZQGFTIQ0uial60EVz1DpRuU2AMXYhpkz3nbcgZ8xJHBVI89XpG3p7lLDD9Wk3LnbBrMPJ9e2zWs4YJJKKA6gUMMKUUzdUu0TsetY9Adg-j-BtH9C-JRUsX6-nzH2jszPhnPP1-AN2dAp0HPU9R-sOmJw7pBJTn-AakBkwg</recordid><startdate>20020501</startdate><enddate>20020501</enddate><creator>LATENSER, Barbara A</creator><creator>KOWAL-VERN, Areta</creator><creator>KIMBALL, Douglas</creator><creator>CHAKRIN, Alan</creator><creator>DUJOVNY, Nadav</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20020501</creationdate><title>A pilot study comparing percutaneous decompression with decompressive laparotomy for acute Abdominal Compartment Syndrome in thermal injury</title><author>LATENSER, Barbara A ; KOWAL-VERN, Areta ; KIMBALL, Douglas ; CHAKRIN, Alan ; DUJOVNY, Nadav</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c341t-a455a6b855e3831045ea62a628428b138a7353b0244fc5b22992102d3d10f6db3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Abdomen</topic><topic>Abdomen - physiopathology</topic><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Analysis of Variance</topic><topic>Ascitic Fluid - metabolism</topic><topic>Biological and medical sciences</topic><topic>Body Surface Area</topic><topic>Burns</topic><topic>Burns - complications</topic><topic>Burns - therapy</topic><topic>Catheters, Indwelling</topic><topic>Chi-Square Distribution</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Compartment Syndromes - etiology</topic><topic>Compartment Syndromes - surgery</topic><topic>Compartment Syndromes - therapy</topic><topic>Decompression, Surgical - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Laparotomy</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pilot Projects</topic><topic>Suction - methods</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LATENSER, Barbara A</creatorcontrib><creatorcontrib>KOWAL-VERN, Areta</creatorcontrib><creatorcontrib>KIMBALL, Douglas</creatorcontrib><creatorcontrib>CHAKRIN, Alan</creatorcontrib><creatorcontrib>DUJOVNY, Nadav</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of burn care & rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>LATENSER, Barbara A</au><au>KOWAL-VERN, Areta</au><au>KIMBALL, Douglas</au><au>CHAKRIN, Alan</au><au>DUJOVNY, Nadav</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A pilot study comparing percutaneous decompression with decompressive laparotomy for acute Abdominal Compartment Syndrome in thermal injury</atitle><jtitle>Journal of burn care & rehabilitation</jtitle><addtitle>J Burn Care Rehabil</addtitle><date>2002-05-01</date><risdate>2002</risdate><volume>23</volume><issue>3</issue><spage>190</spage><epage>195</epage><pages>190-195</pages><issn>0273-8481</issn><eissn>1534-5939</eissn><coden>JBCRD2</coden><abstract>Abdominal Compartment Syndrome (ACS) has multiple causes, and decompressive laparotomy has been the most frequent modality to prevent worsening cardiovascular, respiratory, and renal function. This pilot study evaluated the utility of percutaneous drainage (PD) of peritoneal fluid compared with decompressive laparotomy in burn patients. A 26-month review was conducted. Nine of 13 (69%) study patients developed intra-abdominal hypertension (IAH) that progressed to abdominal compartment syndrome in 4 (31%). All were treated with PD using a diagnostic peritoneal lavage catheter. Peritoneal fluid analysis revealed a sterile plasma ultrafiltrate with electrolyte and other chemistries reflecting patient serum levels. Five patients underwent PD successfully, and their IAH did not progress to ACS. Four patients with greater than 80% TBSA and severe inhalation injury did not respond to PD and required decompressive laparotomy. There was no evidence of bowel edema, ischemia, or necrosis. All patients requiring decompressive laparotomies died either from sepsis or respiratory failure. Percutaneous decompression is a safe and effective method of decreasing IAH and preventing ACS in patients with less than 80% TBSA thermal injury.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>12032369</pmid><doi>10.1097/00004630-200205000-00008</doi><tpages>6</tpages></addata></record> |
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| issn | 0273-8481 1534-5939 |
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| source | MEDLINE; Journals@Ovid Complete; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Abdomen Abdomen - physiopathology Acute Disease Adolescent Adult Analysis of Variance Ascitic Fluid - metabolism Biological and medical sciences Body Surface Area Burns Burns - complications Burns - therapy Catheters, Indwelling Chi-Square Distribution Child Child, Preschool Compartment Syndromes - etiology Compartment Syndromes - surgery Compartment Syndromes - therapy Decompression, Surgical - methods Female Humans Laparotomy Medical sciences Middle Aged Pilot Projects Suction - methods Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Traumas. Diseases due to physical agents Treatment Outcome |
| title | A pilot study comparing percutaneous decompression with decompressive laparotomy for acute Abdominal Compartment Syndrome in thermal injury |
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