Secondary abdominal compartment syndrome is an elusive early complication of traumatic shock resuscitation

Zsolt Balogh, Bruce A. McKinley, Christine S Cocanour, Rosemary A. Kozar, John B. Holcomb, Drue N. Ware, Frederick A. Moore, John Burch, Steve Smith

Research output: Contribution to journalArticle

160 Citations (Scopus)

Abstract

Background: The term secondary abdominal compartment syndrome (ACS) has been applied to describe trauma patients who develop ACS but do not have abdominal injuries. The purpose of this study was to describe major trauma victims who developed secondary ACS during standardized shock resuscitation. Methods: Our prospective database for standardized shock resuscitation was reviewed to obtain before and after abdominal decompression shock related data for secondary ACS patients. Focused chart review was done to confirm time-related outcomes. Results: Over the 30 months period ending May 2001, 11 (9%) of 128 standardized shock resuscitation patients developed secondary ACS. All presented in severe shock (systolic blood pressure 85 ± 5 mm Hg, base deficit 8.6 ± 1.6 mEq/L), with severe injuries (injury severity score 28 ± 3) and required aggressive shock resuscitation (26 ± 2 units of blood, 38 ± 3 L crystalloid within 24 hours). All cases of secondary ACS were recognized and decompressed within 24 hours of hospital admission. After decompression, the bladder pressure and the systemic vascular resistance decreased, while the mean arterial pressure, cardiac index, and static lung compliance increased. The mortality rate was 54%. Those who died failed to respond to decompression with increased cardiac index and did not maintain decreased bladder pressure. Conclusions: Secondary ACS is an early but, if appropriately monitored, recognizable complication in patients with major nonabdominal trauma who require aggressive resuscitation.

Original languageEnglish (US)
Pages (from-to)538-544
Number of pages7
JournalAmerican Journal of Surgery
Volume184
Issue number6
DOIs
StatePublished - Dec 1 2002
Externally publishedYes

Fingerprint

Intra-Abdominal Hypertension
Traumatic Shock
Resuscitation
Shock
Wounds and Injuries
Decompression
Urinary Bladder
Lower Body Negative Pressure
Blood Pressure
Lung Compliance
Pressure
Abdominal Injuries
Injury Severity Score
Vascular Resistance
Arterial Pressure
Databases
Mortality

Keywords

  • Decompression
  • Secondary abdominal compartment syndrome
  • Shock resuscitation

ASJC Scopus subject areas

  • Surgery

Cite this

Secondary abdominal compartment syndrome is an elusive early complication of traumatic shock resuscitation. / Balogh, Zsolt; McKinley, Bruce A.; Cocanour, Christine S; Kozar, Rosemary A.; Holcomb, John B.; Ware, Drue N.; Moore, Frederick A.; Burch, John; Smith, Steve.

In: American Journal of Surgery, Vol. 184, No. 6, 01.12.2002, p. 538-544.

Research output: Contribution to journalArticle

Balogh, Z, McKinley, BA, Cocanour, CS, Kozar, RA, Holcomb, JB, Ware, DN, Moore, FA, Burch, J & Smith, S 2002, 'Secondary abdominal compartment syndrome is an elusive early complication of traumatic shock resuscitation', American Journal of Surgery, vol. 184, no. 6, pp. 538-544. https://doi.org/10.1016/S0002-9610(02)01050-4
Balogh, Zsolt ; McKinley, Bruce A. ; Cocanour, Christine S ; Kozar, Rosemary A. ; Holcomb, John B. ; Ware, Drue N. ; Moore, Frederick A. ; Burch, John ; Smith, Steve. / Secondary abdominal compartment syndrome is an elusive early complication of traumatic shock resuscitation. In: American Journal of Surgery. 2002 ; Vol. 184, No. 6. pp. 538-544.
@article{0958e34cfc244e27a61dc8af088422ef,
title = "Secondary abdominal compartment syndrome is an elusive early complication of traumatic shock resuscitation",
abstract = "Background: The term secondary abdominal compartment syndrome (ACS) has been applied to describe trauma patients who develop ACS but do not have abdominal injuries. The purpose of this study was to describe major trauma victims who developed secondary ACS during standardized shock resuscitation. Methods: Our prospective database for standardized shock resuscitation was reviewed to obtain before and after abdominal decompression shock related data for secondary ACS patients. Focused chart review was done to confirm time-related outcomes. Results: Over the 30 months period ending May 2001, 11 (9{\%}) of 128 standardized shock resuscitation patients developed secondary ACS. All presented in severe shock (systolic blood pressure 85 ± 5 mm Hg, base deficit 8.6 ± 1.6 mEq/L), with severe injuries (injury severity score 28 ± 3) and required aggressive shock resuscitation (26 ± 2 units of blood, 38 ± 3 L crystalloid within 24 hours). All cases of secondary ACS were recognized and decompressed within 24 hours of hospital admission. After decompression, the bladder pressure and the systemic vascular resistance decreased, while the mean arterial pressure, cardiac index, and static lung compliance increased. The mortality rate was 54{\%}. Those who died failed to respond to decompression with increased cardiac index and did not maintain decreased bladder pressure. Conclusions: Secondary ACS is an early but, if appropriately monitored, recognizable complication in patients with major nonabdominal trauma who require aggressive resuscitation.",
keywords = "Decompression, Secondary abdominal compartment syndrome, Shock resuscitation",
author = "Zsolt Balogh and McKinley, {Bruce A.} and Cocanour, {Christine S} and Kozar, {Rosemary A.} and Holcomb, {John B.} and Ware, {Drue N.} and Moore, {Frederick A.} and John Burch and Steve Smith",
year = "2002",
month = "12",
day = "1",
doi = "10.1016/S0002-9610(02)01050-4",
language = "English (US)",
volume = "184",
pages = "538--544",
journal = "American Journal of Surgery",
issn = "0002-9610",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Secondary abdominal compartment syndrome is an elusive early complication of traumatic shock resuscitation

AU - Balogh, Zsolt

AU - McKinley, Bruce A.

AU - Cocanour, Christine S

AU - Kozar, Rosemary A.

AU - Holcomb, John B.

AU - Ware, Drue N.

AU - Moore, Frederick A.

AU - Burch, John

AU - Smith, Steve

PY - 2002/12/1

Y1 - 2002/12/1

N2 - Background: The term secondary abdominal compartment syndrome (ACS) has been applied to describe trauma patients who develop ACS but do not have abdominal injuries. The purpose of this study was to describe major trauma victims who developed secondary ACS during standardized shock resuscitation. Methods: Our prospective database for standardized shock resuscitation was reviewed to obtain before and after abdominal decompression shock related data for secondary ACS patients. Focused chart review was done to confirm time-related outcomes. Results: Over the 30 months period ending May 2001, 11 (9%) of 128 standardized shock resuscitation patients developed secondary ACS. All presented in severe shock (systolic blood pressure 85 ± 5 mm Hg, base deficit 8.6 ± 1.6 mEq/L), with severe injuries (injury severity score 28 ± 3) and required aggressive shock resuscitation (26 ± 2 units of blood, 38 ± 3 L crystalloid within 24 hours). All cases of secondary ACS were recognized and decompressed within 24 hours of hospital admission. After decompression, the bladder pressure and the systemic vascular resistance decreased, while the mean arterial pressure, cardiac index, and static lung compliance increased. The mortality rate was 54%. Those who died failed to respond to decompression with increased cardiac index and did not maintain decreased bladder pressure. Conclusions: Secondary ACS is an early but, if appropriately monitored, recognizable complication in patients with major nonabdominal trauma who require aggressive resuscitation.

AB - Background: The term secondary abdominal compartment syndrome (ACS) has been applied to describe trauma patients who develop ACS but do not have abdominal injuries. The purpose of this study was to describe major trauma victims who developed secondary ACS during standardized shock resuscitation. Methods: Our prospective database for standardized shock resuscitation was reviewed to obtain before and after abdominal decompression shock related data for secondary ACS patients. Focused chart review was done to confirm time-related outcomes. Results: Over the 30 months period ending May 2001, 11 (9%) of 128 standardized shock resuscitation patients developed secondary ACS. All presented in severe shock (systolic blood pressure 85 ± 5 mm Hg, base deficit 8.6 ± 1.6 mEq/L), with severe injuries (injury severity score 28 ± 3) and required aggressive shock resuscitation (26 ± 2 units of blood, 38 ± 3 L crystalloid within 24 hours). All cases of secondary ACS were recognized and decompressed within 24 hours of hospital admission. After decompression, the bladder pressure and the systemic vascular resistance decreased, while the mean arterial pressure, cardiac index, and static lung compliance increased. The mortality rate was 54%. Those who died failed to respond to decompression with increased cardiac index and did not maintain decreased bladder pressure. Conclusions: Secondary ACS is an early but, if appropriately monitored, recognizable complication in patients with major nonabdominal trauma who require aggressive resuscitation.

KW - Decompression

KW - Secondary abdominal compartment syndrome

KW - Shock resuscitation

UR - http://www.scopus.com/inward/record.url?scp=0036911016&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036911016&partnerID=8YFLogxK

U2 - 10.1016/S0002-9610(02)01050-4

DO - 10.1016/S0002-9610(02)01050-4

M3 - Article

VL - 184

SP - 538

EP - 544

JO - American Journal of Surgery

JF - American Journal of Surgery

SN - 0002-9610

IS - 6

ER -