Abdominal compartment syndrome – the prevention and treatment of possible lethal complications following hip arthroscopy: a case report

Table 3 Algorithm-related physical and physiological signs of fluid extravasation syndrome and abdominal compartment syndrome: initiated treatment options to reduce intra-abdominal pressure

Physical and physiologic signs of fluid extravasation	Abdominal compartment syndrome clinical syndromes	Initiate treatment to reduce intra-abdominal pressure
Cardiac arrhythmias	Systolic blood pressure less than 90mmHg or need for catecholamine support	Improve abdominal wall compliance
Cardiac arrhythmias		Sedation and analgesia. Neuromuscular blockade. Avoid head of bed >30 degrees
Hypotension	PaO₂ 60mmHg or less or need for mechanical ventilation	Correct positive fluid balance
Hypotension	PaO₂ 60mmHg or less or need for mechanical ventilation	Avoid excessive fluid resuscitation. Diuretics. Colloids/hypertonic fluids. Hemodialysis/ultrafiltration
Oxygen saturation <95	Need for hemodialysis or creatinine level greater than 177umol/L after rehydration	Organ support. Maintain APP >60mmHg with vasopressors. Optimize ventilation, alveolar recruitment. Use transmural airway pressures
		Pplattm = Pplat – IAP. Consider using volumetric preload indices. If using PAOP/CVP, use transmural pressures
		PAOPtm = PAOP – 0.5 × IAP CVPtm = CVP – 0.5 × IAP
Hypothermia (core temperature <35°C)	Unresponsiveness	Evacuate intraluminal contents. Nasogastric decompression. Rectal decompression. Gastro-/colo-prokinetic agents
Shortness of breath	Shortness of breath/apnea
Peak pressure ↑ on artificial ventilation

Abbreviations: APP abdominal perfusion pressure, CVP central venous pressure, IAP intra-abdominal pressure, PaO ₂ oxygen partial pressure arterial, PAOP pulmonary artery occlusion pressure, Pplat plateau pressure, Pplattm transmural plateau pressure, tm transmural.

ISSN: 1752-1947