Lethal abdominal compartment syndrome after extracorporeal cardiopulmonary resuscitation in a patient with out-of-hospital cardiac arrest: a case report
Tóm tắt
Clinical attempts of extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) have increased in recent years; however, it also has life-threatening complications. Massive fluid and transfusion resuscitation, shock status, or low cardiac output status during ECPR may lead to ascites and interstitial edema, resulting in secondary abdominal compartment syndrome (ACS). A 43-year-old male patient was admitted to the emergency department due to cardiac arrest. Due to refractory ventricular fibrillation, ECPR was initiated. Approximately, 3 h after extracorporeal membrane oxygenation support, abdominal distension and rigidity developed. Therefore, ACS was suspected. Decompression laparotomy was required to relieve elevated intra-abdominal pressure. We report a case of a patient with OHCA who developed lethal ACS after ECPR. Despite this, the patient was able to recover from several major crises. Regardless of how lethal the patient is, if compartment syndrome develops in any part of the body, we should aggressively consider surgical decompression.
Tài liệu tham khảo
MacLaren G, Masoumi A, Brodie D. ECPR for out-of-hospital cardiac arrest: more evidence is needed. Crit Care. 2020;24(1):7.
Chang WH. Decompressive laparotomy for abdominal compartment syndrome in patient on extracorporeal life support: a first survival case among adults with literature review. Hong Kong J Emerg Med. 2017;25(3):166–8.
Augustin P, Lasocki S, Dufour G, Rode J, Karsenti A, Al-Attar N, et al. Abdominal compartment syndrome due to extracorporeal membrane oxygenation in adults. Ann Thorac Surg. 2010;90(3):e40–1.
Maj G, Calabro MG, Pieri M, Melisurgo G, Zangrillo A, Pappalardo F. Abdominal compartment syndrome during extracorporeal membrane oxygenation. J Cardiothorac Vasc Anesth. 2012;26(5):890–2.
Rollins MD, Deamorim-Filho J, Scaife ER, Hubbard A, Barnhart DC. Decompressive laparotomy for abdominal compartment syndrome in children on ECMO: effect on support and survival. J Pediatr Surg. 2013;48(7):1509–13.
Kim H, Cho YH. Role of extracorporeal cardiopulmonary resuscitation in adults. Acute Crit Care. 2020;35(1):1–9.
Hecker A, Hecker B, Hecker M, Riedel JG, Weigand MA, Padberg W. Acute abdominal compartment syndrome: current diagnostic and therapeutic options. Langenbecks Arch Surg. 2016;401(1):15–24.
Kim H, Paek JH, Song JH, Lee H, Jhee JH, Park S, et al. Permissive fluid volume in adult patients undergoing extracorporeal membrane oxygenation treatment. Crit Care. 2018;22(1):270.
Djordjevic I, Maier-Trauth J, Gerfer S, Elskamp M, Muehlbauer T, Maul A, et al. Fluid management in veno-arterial extracorporeal membrane oxygenation therapy-analysis of an experimental pig model. J Clin Med. 2023;12(16):5330.
Shah SK, Jimenez F, Letourneau PA, Walker PA, Moore-Olufemi SD, Stewart RH, et al. Strategies for modulating the inflammatory response after decompression from abdominal compartment syndrome. Scand J Trauma Resusc Emerg Med. 2012;20:25.
Al-Fares A, Pettenuzzo T, Del Sorbo L. Extracorporeal life support and systemic inflammation. Intensive Care Med Exp. 2019;7(Suppl 1):46.