Abdominal compartment syndrome in patients requiring extracorporeal membrane oxygenation

Abstract

Objective: To investigate the prevalence and risk factor for abdominal compartment syndrome (ACS) in patients requiring extracorporeal membrane oxygenation (ECMO), to assess the effect of decompressive laparotomy (DL) and to evaluate the impact of ACS on prognosis. Methods: 1643 patients requiring ECMO from January 2010 to June 2020 at the University Hospital Regensburg were eligible for this analysis. If ACS was clinically suspected, screening was conducted by measuring intraabdominal pressure (IAP) via trans-bladder technique. ACS was defined as IAP>20mmHg, survival as successful discharge from hospital. Results: The prevalence of ACS was 3.3% (31/944) in veno-arterial and 2.3% (16/699) in veno-venous ECMO. In multivariate analysis, lactate and fibrinogen were associated with ACS. Ventilation and IAP and improved significantly one hour after DL, lactate after 24 hours (Fig 1). Though higher disease severity at baseline, survival was comparable in the DL and the no DL group (27% vs. 33%, p=0.633). Fig. 1: ![Figure][1]</img> Conclusion: Prevalence of ACS was 3.3% in veno-arterial and 2.3% in veno-venous ECMO patients. Lactate and fibrinogen were associated with ACS. DL resulted in improved IAP, pulmonary compliance and sustained stabilization of hemodynamic parameters. Despite higher disease severity comparing the DL to the no DL group, survival was similar. Thus, DL shouldn’t be refused to ACS-ECMO patients if necessary. Footnotes Cite this article as: ERJ Open Research 2022; 8: Suppl. 9, 24. This article was presented at the 2022 ERS Respiratory Failure and Mechanical Ventilation Conference, in session “Poster Session 2”. This is an ERS Respiratory Failure and Mechanical Ventilation Conference abstract. No full-text version is available. Further material to accompany this abstract may be available at [www.ers-education.org][2] (ERS member access only). [1]: pending:yes [2]: http://www.ers-education.org