Intra-abdominal hypertension complicating pancreatitis-induced acute respiratory distress syndrome

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Authors

Lee Feddy, Julian Barker, Pete Fawcett, Ignacio Malagon

Abstract/Text

Background
Severe acute pancreatitis is associated with sever multiorgan failure from 15 to 50%, depending on the series. In some of these patients, conventional methods of ventilation and respiratory support will fail, demanding the use of extracorporeal membrane oxygenation (ECMO). Abdominal compartment syndrome is potentially harmful in this cohort of patients. We describe the successful treatment of three patients with severe acute pancreatitis who underwent respiratory ECMO and where intra abdominal pressure was monitored regularly.

Methods
Retrospective review of case notes.

Results
Three patients with severe acute pancreatitis requiring ECMO suffered from increased intra abdominal pressure during their ICU stay. No surgical interventions were taken to relieve abdominal compartment syndrome. Survival to hospital discharge was 100%.

Conclusions
Monitoring intraabdominal pressure is a valuable adjunct to decision making while caring for these high-risk critically ill patients.

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