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Fluid Management, Intra-Abdominal Hypertension and the Abdominal Compartment Syndrome: A Narrative Review

Authors :
Rita Jacobs
Robert D. Wise
Ivan Myatchin
Domien Vanhonacker
Andrea Minini
Michael Mekeirele
Andrew W. Kirkpatrick
Bruno M. Pereira
Michael Sugrue
Bart De Keulenaer
Zsolt Bodnar
Stefan Acosta
Janeth Ejike
Salar Tayebi
Johan Stiens
Colin Cordemans
Niels Van Regenmortel
Paul W. G. Elbers
Xavier Monnet
Adrian Wong
Wojciech Dabrowski
Philippe G. Jorens
Jan J. De Waele
Derek J. Roberts
Edward Kimball
Annika Reintam Blaser
Manu L. N. G. Malbrain
Source :
Life, Vol 12, Iss 9, p 1390 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

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 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.

Details

Language :
English
ISSN :
20751729
Volume :
12
Issue :
9
Database :
Directory of Open Access Journals
Journal :
Life
Publication Type :
Academic Journal
Accession number :
edsdoj.448986127524232a5dd8d271581b3bf
Document Type :
article
Full Text :
https://doi.org/10.3390/life12091390