The utilization of ultrasound in the management of patients with abdominal compartment syndrome
LIN Zhu,GAO Hong-mei,XU Hua
Abstract:
Objective To explore the role of ultrasonography in the management of patients with abdominal compartment syndrome (ACS). Methods Thirty patients diagnosed with ACS were included as research subjects, employing ultrasonography as an auxiliary tool for ACS management. Results The study encompassed 30 patients, with an average age of (60.0±14.6) years, 70% of whom were male, and an average BMI of (25.0±2.4)kg/m2. Eighty percent of the patients with ACS required vasopressor support due to hypotension, with the most common causes of ACS being sepsis due to intra-abdominal infection, and intestinal obstruction, accounting for 40% and 20% respectively. After five consecutive days of treatment, the average intra-abdominal pressure (IAP) decreased from (23±2.3)mmHg at admission to (13±2.2)mmHg on the fifth day. The patient's average APP on the first day was (62±5.5)mmHg, which rose to (90±5.4)mmHg by the fifth day of treatment. However, a significant increase in urine output was observed starting from the third day, accompanied by a decrease in the renal artery resistance index to 0.65±0.06. Ultrasound indicated intestinal dysfunction in 10 patients (33.3% of the total) on the first day, which was reduced to one patient by the fifth day following gastrointestinal decompression and enema treatments; ultrasonography could identify intestinal contents, further guiding decompression or enema procedures. Additionally, for eight patients with concurrent ascites, ultrasound-guided paracentesis was performed. Conclusion In the treatment and management of patients with ACS, compared to the traditional application of APP for assessing perfusion of intra-abdominal organs, the renal artery resistance index measured by ultrasonography can more sensitively evaluate renal perfusion. Ultrasound has advantages in evaluating intestinal function, identifying contents within the intestinal lumen, guiding decompression and enema administration, and guiding the placement of abdominal fluid drainage tubes.
