PMID- 23790395
OWN - NLM
STAT- MEDLINE
DCOM- 20141117
LR  - 20220318
IS  - 1879-1409 (Electronic)
IS  - 0305-4179 (Linking)
VI  - 40
IP  - 1
DP  - 2014 Feb
TI  - Respiratory functions of burn patients undergoing decompressive laparotomy due to 
      secondary abdominal compartment syndrome.
PG  - 120-6
LID - S0305-4179(13)00154-X [pii]
LID - 10.1016/j.burns.2013.05.007 [doi]
AB  - INTRODUCTION: The development of secondary abdominal compartment syndrome (ACS) 
      is associated with multiple organ dysfunction. There is little information about 
      the effects of decompressive laparotomy (DL) on respiratory function (RF) in burn 
      patients developing ACS. PATIENTS AND METHODS: We retrospectively obtained data 
      characterising RF from the database of an adult burn intensive care unit (BICU). 
      Peak inspiratory pressure (Pip), PaO2/FiO2-ratio (P/F), static compliance (Cstat) 
      and airway resistance (Raw) were analysed over the course of 60 h at 8 time 
      points relative to DL. RESULTS: Thirty-five patients with ACS underwent DL with a 
      mean percentage of total burned body surface area (TBSA) 39 +/- 23% and mean 
      intra-abdominal pressure 33 +/- 7 mmHg. All patients presented with significantly 
      deteriorating RF within 12h of DL (Pip 33 +/- 4 to 39 +/- 7 cm/H2O, p=0.003; P/F 232 
      +/- 59 to 160 +/- 55 mmHg, p<0.001, Cstat 34 +/- 5 to 26 +/- 6 mL/cmH2O, p<0.001; Raw 18 
      +/- 3 to 24 +/- 9 cm H2O/L/s, p=0.02). All these parameters improved significantly 
      (p<0.001) after DL, regardless of the presence of inhalation injury or torso 
      burns. Mortality was 71.4%. CONCLUSIONS: Variables characterising RF demonstrated 
      a rapid deterioration before and a significant and sustained improvement after DL 
      in burn patients developing ACS. Despite these respiratory improvements, DL was 
      associated with low survival rates. Secondary ACS remains a challenge in burn 
      patients and thus warrants particular attention during intensive care treatment.
CI  - Copyright (c) 2013 Elsevier Ltd and ISBI. All rights reserved.
FAU - Struck, Manuel F
AU  - Struck MF
AD  - Department of Anaesthesiology and Intensive Care Medicine, University Hospital, 
      Leipzig, Germany; Department of Plastic and Hand Surgery, Burn Trauma Centre, 
      Bergmannstrost Hospital, Halle/Saale, Germany. Electronic address: 
      manuelstruck@web.de.
FAU - Reske, Andreas W
AU  - Reske AW
AD  - Department of Anaesthesiology and Intensive Care Medicine, University Hospital, 
      Leipzig, Germany.
FAU - Schmidt, Thomas
AU  - Schmidt T
AD  - Department of Medical Psychology, Bergmannstrost Hospital, Halle/Saale, Germany.
FAU - Hilbert, Peter
AU  - Hilbert P
AD  - Department of Anaesthesiology, Intensive Care and Emergency Medicine, 
      Bergmannstrost Hospital, Halle/Saale, Germany.
FAU - Steen, Michael
AU  - Steen M
AD  - Department of Plastic and Hand Surgery, Burn Trauma Centre, Bergmannstrost 
      Hospital, Halle/Saale, Germany.
FAU - Wrigge, Hermann
AU  - Wrigge H
AD  - Department of Anaesthesiology and Intensive Care Medicine, University Hospital, 
      Leipzig, Germany.
LA  - eng
PT  - Journal Article
DEP - 20130618
PL  - Netherlands
TA  - Burns
JT  - Burns : journal of the International Society for Burn Injuries
JID - 8913178
SB  - IM
MH  - Adult
MH  - Aged
MH  - Airway Resistance/physiology
MH  - Body Surface Area
MH  - Burns/*complications
MH  - Burns, Inhalation/complications
MH  - Cohort Studies
MH  - *Decompression, Surgical
MH  - Female
MH  - Humans
MH  - Inhalation/physiology
MH  - Intra-Abdominal Hypertension/etiology/physiopathology/*surgery
MH  - Laparotomy
MH  - Lung/*physiopathology
MH  - Male
MH  - Middle Aged
MH  - Multiple Organ Failure/etiology/physiopathology
MH  - Respiratory Function Tests
MH  - Respiratory Insufficiency/etiology/*physiopathology
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Abdominal compartment syndrome
OT  - Burn
OT  - Laparotomy
OT  - Respiratory function
EDAT- 2013/06/25 06:00
MHDA- 2014/11/18 06:00
CRDT- 2013/06/25 06:00
PHST- 2012/11/21 00:00 [received]
PHST- 2013/04/23 00:00 [revised]
PHST- 2013/05/21 00:00 [accepted]
PHST- 2013/06/25 06:00 [entrez]
PHST- 2013/06/25 06:00 [pubmed]
PHST- 2014/11/18 06:00 [medline]
AID - S0305-4179(13)00154-X [pii]
AID - 10.1016/j.burns.2013.05.007 [doi]
PST - ppublish
SO  - Burns. 2014 Feb;40(1):120-6. doi: 10.1016/j.burns.2013.05.007. Epub 2013 Jun 18.