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World Journal of Surgery
Published in: World Journal of Surgery 4/2021

01-04-2021 | Laparotomy | Original Scientific Report

Abdominal Decompression after Cardiac Surgery: Outcome of 42 Patients with Abdominal Compartment Syndrome

Authors: Michaela Ramser, Philippe M. Glauser, Tracy R. Glass, Benjamin Weixler, Martin T. R. Grapow, Henry Hoffmann, Philipp Kirchhoff

Published in: World Journal of Surgery | Issue 4/2021

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Abstract

Background

Up to 50% of patients in intensive care units develop intraabdominal hypertension (IAH) in the course of medical treatment. If not detected on time and treated adequately, IAH may develop into an abdominal compartment syndrome (ACS) which is associated with a high mortality rate. Patients undergoing cardiac surgery are especially prone to develop ACS due to several risk factors including intraoperative hypothermia, fluid resuscitation and acidosis. We investigated patients who developed ACS after cardiac surgery and analyzed potential risk factors, treatment and outcome.

Methods

From 2011 to 2016, patients with ACS after cardiac surgery requiring decompressive laparotomy were prospectively recorded. Patient characteristics, details on the cardiac surgery, mortality rate and type of treatment of the open abdomen were analyzed.

Results

Incidence of ACS in cardiac surgery patients was 1.0% (n = 42/4128), with a mortality rate of 57%. Ejection fraction, Euroscore2 as well as the perfusion time are independent risk factors for the development of ACS. The outcome of patients with ACS was independent of elective versus emergency surgery, gender, age, BMI or ASA score. In the 18 surviving patients, fascial closure was achieved in 72% after a median of 9 days.

Conclusion

Abdominal compartment syndrome is a rare but serious complication after cardiac surgery with a high mortality rate. Independent risk factors for ACS were identified. Negative pressure wound therapy seems to promote and allow early fascia closure of the abdomen and represents therefore a likely benefit for the patient.
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Metadata
Title
Abdominal Decompression after Cardiac Surgery: Outcome of 42 Patients with Abdominal Compartment Syndrome
Authors
Michaela Ramser
Philippe M. Glauser
Tracy R. Glass
Benjamin Weixler
Martin T. R. Grapow
Henry Hoffmann
Philipp Kirchhoff
Publication date
01-04-2021
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 4/2021
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-020-05917-0

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