Intra-Abdominal Hypertension and Abdominal Compartment Syndrome in COVID-19: Diagnosis, Prevention, Treatment

Abstract

Introduction. New COVID-19 coronavirus infection negatively influenced the surgical service. Clinical recommendations for the treatment of surgical patients were adjusted to the new conditions of unfavorable epidemiologic conditions with reorientation to urgent minimally invasive surgical care. Therefore, the generally accepted diagnostic and treatment programs could not be applied due to the overwhelming admission of patients in extremely severe condition. Such programs embrace treatment and prevention of intra-abdominal hypertension and abdominal compartment syndrome. Aim. To analyze the treatment results of patients with COVID-19 infection in covid hospitals, complicated by abdominal surgical pathology and associated with abdominal surgical disease, in terms of diagnosis, treatment and prevention of pathological conditions leading to increased intra-abdominal pressure. Materials and methods. The study analyzed the treatment results of 1900 patients in covid hospitals with different surgical capabilities, where they were provided with diagnostic, therapeutic and preventive measures in order to prevent abdominal compartment syndrome, i.e. management of intra-abdominal hypertension and abdominal compartment syndrome was performed according to the diagnostic and treatment program. Results and discussion. 67 patients (3.5%) in the clinical group developed an abdominal surgical complication, or covid infection was associated with an acute abdominal surgical disease. In case of indications for emergency surgery, surgical tactics consisted in minimally invasive techniques and regional anesthesia; a development of compartment syndrome was managed with emergency decompressive laparotomy. Conclusion. The implementation of the diagnostic and treatment program of intra-abdominal hypertension and abdominal compartment syndrome management in the clinical group of COVID-patients enabled compartment syndrome to be prevented in 3.5% of patients and early decompressive laparotomy to be performed in 1.5% of patients in case of its development. The mortality associated with abdominal complications of COVID-19 comprised 1.3% in the clinical group.