Fluid Management, Intra-Abdominal Hypertension and the Abdominal Compartment Syndrome : A Narrative Review
(2022) In Life 12(9).- Abstract
Background: General pathophysiological mechanisms regarding associations between fluid administration and intra-abdominal hypertension (IAH) are evident, but specific effects of type, amount, and timing of fluids are less clear. Objectives: This review aims to summarize current knowledge on associations between fluid administration and intra-abdominal pressure (IAP) and fluid management in patients at risk of intra-abdominal hypertension and abdominal compartment syndrome (ACS). Methods: We performed a structured literature search from 1950 until May 2021 to identify evidence of associations between fluid management and intra-abdominal pressure not limited to any specific study or patient population. Findings were summarized based on... (More)
Background: General pathophysiological mechanisms regarding associations between fluid administration and intra-abdominal hypertension (IAH) are evident, but specific effects of type, amount, and timing of fluids are less clear. Objectives: This review aims to summarize current knowledge on associations between fluid administration and intra-abdominal pressure (IAP) and fluid management in patients at risk of intra-abdominal hypertension and abdominal compartment syndrome (ACS). Methods: We performed a structured literature search from 1950 until May 2021 to identify evidence of associations between fluid management and intra-abdominal pressure not limited to any specific study or patient population. Findings were summarized based on the following information: general concepts of fluid management, physiology of fluid movement in patients with intra-abdominal hypertension, and data on associations between fluid administration and IAH. Results: We identified three randomized controlled trials (RCTs), 38 prospective observational studies, 29 retrospective studies, 18 case reports in adults, two observational studies and 10 case reports in children, and three animal studies that addressed associations between fluid administration and IAH. Associations between fluid resuscitation and IAH were confirmed in most studies. Fluid resuscitation contributes to the development of IAH. However, patients with IAH receive more fluids to manage the effect of IAH on other organ systems, thereby causing a vicious cycle. Timing and approach to de-resuscitation are of utmost importance, but clear indicators to guide this decision-making process are lacking. In selected cases, only surgical decompression of the abdomen can stop deterioration and prevent further morbidity and mortality. Conclusions: Current evidence confirms an association between fluid resuscitation and secondary IAH, but optimal fluid management strategies for patients with IAH remain controversial.
(Less)
- author
- Jacobs, Rita
; Wise, Robert D.
; Myatchin, Ivan
; Vanhonacker, Domien
; Minini, Andrea
; Mekeirele, Michael
; Kirkpatrick, Andrew W.
; Pereira, Bruno M.
; Sugrue, Michael
; De Keulenaer, Bart
; Bodnar, Zsolt
; Acosta, Stefan
LU
; Ejike, Janeth
; Tayebi, Salar
; Stiens, Johan
; Cordemans, Colin
; Van Regenmortel, Niels
; Elbers, Paul W.G.
; Monnet, Xavier
; Wong, Adrian
; Dabrowski, Wojciech
; Jorens, Philippe G.
; De Waele, Jan J.
; Roberts, Derek J.
; Kimball, Edward
; Reintam Blaser, Annika
and Malbrain, Manu L.N.G.
(Less) - organization
- publishing date
- 2022-09
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- abdominal compartment syndrome, abdominal hypertension, colloids, crystalloids, fluid therapy, hypertonic, maintenance, open abdomen, resuscitation, sepsis
- in
- Life
- volume
- 12
- issue
- 9
- article number
- 1390
- publisher
- MDPI AG
- external identifiers
-
- pmid:36143427
- scopus:85138673893
- ISSN
- 0024-3019
- DOI
- 10.3390/life12091390
- language
- English
- LU publication?
- yes
- id
- c2ca4948-2b19-4d2b-964d-f1c9e1e19515
- date added to LUP
- 2022-12-12 11:36:22
- date last changed
- 2024-04-18 16:16:12
@article{c2ca4948-2b19-4d2b-964d-f1c9e1e19515,
abstract = {{<p>Background: General pathophysiological mechanisms regarding associations between fluid administration and intra-abdominal hypertension (IAH) are evident, but specific effects of type, amount, and timing of fluids are less clear. Objectives: This review aims to summarize current knowledge on associations between fluid administration and intra-abdominal pressure (IAP) and fluid management in patients at risk of intra-abdominal hypertension and abdominal compartment syndrome (ACS). Methods: We performed a structured literature search from 1950 until May 2021 to identify evidence of associations between fluid management and intra-abdominal pressure not limited to any specific study or patient population. Findings were summarized based on the following information: general concepts of fluid management, physiology of fluid movement in patients with intra-abdominal hypertension, and data on associations between fluid administration and IAH. Results: We identified three randomized controlled trials (RCTs), 38 prospective observational studies, 29 retrospective studies, 18 case reports in adults, two observational studies and 10 case reports in children, and three animal studies that addressed associations between fluid administration and IAH. Associations between fluid resuscitation and IAH were confirmed in most studies. Fluid resuscitation contributes to the development of IAH. However, patients with IAH receive more fluids to manage the effect of IAH on other organ systems, thereby causing a vicious cycle. Timing and approach to de-resuscitation are of utmost importance, but clear indicators to guide this decision-making process are lacking. In selected cases, only surgical decompression of the abdomen can stop deterioration and prevent further morbidity and mortality. Conclusions: Current evidence confirms an association between fluid resuscitation and secondary IAH, but optimal fluid management strategies for patients with IAH remain controversial.</p>}},
author = {{Jacobs, Rita and Wise, Robert D. and Myatchin, Ivan and Vanhonacker, Domien and Minini, Andrea and Mekeirele, Michael and Kirkpatrick, Andrew W. and Pereira, Bruno M. and Sugrue, Michael and De Keulenaer, Bart and Bodnar, Zsolt and Acosta, Stefan and Ejike, Janeth and Tayebi, Salar and Stiens, Johan and Cordemans, Colin and Van Regenmortel, Niels and Elbers, Paul W.G. and Monnet, Xavier and Wong, Adrian and Dabrowski, Wojciech and Jorens, Philippe G. and De Waele, Jan J. and Roberts, Derek J. and Kimball, Edward and Reintam Blaser, Annika and Malbrain, Manu L.N.G.}},
issn = {{0024-3019}},
keywords = {{abdominal compartment syndrome; abdominal hypertension; colloids; crystalloids; fluid therapy; hypertonic; maintenance; open abdomen; resuscitation; sepsis}},
language = {{eng}},
number = {{9}},
publisher = {{MDPI AG}},
series = {{Life}},
title = {{Fluid Management, Intra-Abdominal Hypertension and the Abdominal Compartment Syndrome : A Narrative Review}},
url = {{http://dx.doi.org/10.3390/life12091390}},
doi = {{10.3390/life12091390}},
volume = {{12}},
year = {{2022}},
}