TY - JOUR
T1 - Fluid Management, Intra-Abdominal Hypertension and the Abdominal Compartment Syndrome
T2 - A Narrative Review
AU - Jacobs, Rita
AU - Wise, Robert D.
AU - Myatchin, Ivan
AU - Vanhonacker, Domien
AU - Minini, Andrea
AU - Mekeirele, Michael
AU - Kirkpatrick, Andrew W.
AU - Pereira, Bruno M.
AU - Sugrue, Michael
AU - De Keulenaer, Bart
AU - Bodnar, Zsolt
AU - Acosta, Stefan
AU - Ejike, Janeth
AU - Tayebi, Salar
AU - Stiens, Johan
AU - Cordemans, Colin
AU - Van Regenmortel, Niels
AU - Elbers, Paul W.G.
AU - Monnet, Xavier
AU - Wong, Adrian
AU - Dabrowski, Wojciech
AU - Jorens, Philippe G.
AU - De Waele, Jan J.
AU - Roberts, Derek J.
AU - Kimball, Edward
AU - Reintam Blaser, Annika
AU - Malbrain, Manu L.N.G.
PY - 2022/9
Y1 - 2022/9
N2 - 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.
AB - 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.
KW - abdominal compartment syndrome
KW - abdominal hypertension
KW - colloids
KW - crystalloids
KW - fluid therapy
KW - hypertonic
KW - maintenance
KW - open abdomen
KW - resuscitation
KW - sepsis
U2 - 10.3390/life12091390
DO - 10.3390/life12091390
M3 - Review article
C2 - 36143427
AN - SCOPUS:85138673893
SN - 0024-3019
VL - 12
JO - Life
JF - Life
IS - 9
M1 - 1390
ER -