Lubnow, Matthias and Koch, Chiara T. and Malfertheiner, Maximilian V. and Foltan, Maik and Philipp, Alois and Lunz, Dirk and Schlitt, Hans J. and Brennfleck, Frank and Dietl, Barbara and Hamer, Okka W. and Stadlbauer, Andrea and Schmid, Christof and Zeman, Florian and Mueller, Thomas and Fisser, Christoph (2025) Prevalence, Predictors and Decompressive Laparotomy in Abdominal Compartment Syndrome in Patients Requiring Extracorporeal Membrane Oxygenation. JOURNAL OF CLINICAL MEDICINE, 14 (3): 855. ISSN , 2077-0383
Full text not available from this repository. (Request a copy)Abstract
Background: Critically ill patients requiring extracorporeal membrane oxygenation (ECMO) have several risk factors to suffer from abdominal compartment syndrome (ACS). Little is known about this subgroup. The aim of this study was to investigate the prevalence and associated factors for ACS in patients requiring ECMO to assess the effect of decompressive laparotomy (DL) and the impact on mortality. Methods: This retrospective observational study analyzed adult patients requiring ECMO in four intensive care units at the University Medical Center Regensburg between 01/2010 and 06/2020. Patients with clinically suspected ACS were screened by measuring intra-abdominal pressure (IAP) with the trans-bladder technique. ACS was defined as IAP > 20 mmHg and survival was defined as successful discharge from hospital. Results: The prevalence of ACS in non-ECMO ICU patients was 0.8% (291/36,795) and 2.9% (47/1643) in ECMO patients. In the subgroup of resuscitated ECMO patients, ACS was present in 4.2% (32/766). Procalcitonin was associated with ACS. ECMO patients with ACS receiving DL were significantly more ill compared to those without DL (SOFA score at ICU admission 18 [15; 20], vs. 16 [13; 17], p = 0.048). DL decreased IAP and significantly improved ventilation; vasopressor and lactate stabilized within 24 hours. Survival was comparable between the DL and the non-DL groups (11% [1/9] vs. 14% [1/7], p = 1.000). Conclusions: ECMO patients are at high risk of developing ACS, even more so for resuscitated patients. This and high procalcitonin may be taken into consideration when screening for ACS. Decompressive laparotomy did improve respiratory compliance and stabilized hemodynamic parameters with low rates of complication. Even though patients that received DL were significantly more ill, the mortality rates were not higher.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CRITICALLY-ILL PATIENTS; INTRAABDOMINAL HYPERTENSION; ANTICOAGULATION PRACTICES; FAILURE; SUPPORT; ECMO; abdominal compartment syndrome; ECLS; decompressive laparotomy; prevalence |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Innere Medizin II Medicine > Lehrstuhl für Röntgendiagnostik Medicine > Lehrstuhl für Strahlentherapie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Jun 2026 08:37 |
| Last Modified: | 23 Jun 2026 08:37 |
| URI: | https://pred.uni-regensburg.de/id/eprint/66005 |
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