Muangman Pornprom, Muangman Saipin, Suvanchote Supaparn, Benjathanung Rachanee
Burn Unit, Trauma Division, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2007 Feb;90(2):384-90.
Abdominal compartment syndrome (ACS) is consistently reported to have significant morbidity and mortality. Major burn patients who receive massive fluid resuscitation are at high-risk for this condition. Close monitoring of ACS is necessary for these patients. Prolonged unrelieved intra-abdominal pressure (IAP) at greater than 20 mmHg can produce significant morbidity and mortality. The most widely accepted and feasible way to measure IAP is via the draining port of a standard urinary catheter Siriraj burn unit developed its own device from simple equipment that can be found easily in the hospital. It proved to be useful, cheap, and effective in monitoring intra-abdominal pressure. The present study described techniques of using this device for monitoring and early detection of ACS. Five major burn patients > or = 40% Total body surface area (TBSA) was measured by IAP measurement via foley catheter using the Siriraj device catheter compared to direct measurement via peritoneal catheter. There was no difference of IAP between the two methods (p = 0.48). This suggested that Siriraj device catheter was useful, not invasive, and effective in reflection of actually IAP Siriraj burn unit suggested IAP measurement in all major burns > or = 40% TBSA to early recognize and treat intra-abdominal hypertension(IAH) that can lead to ACS. Early detection of this syndrome might decrease the adverse effects after increasing abdominal pressure that can cause organ dysfunction.
腹腔间隔室综合征(ACS)一直被报道具有较高的发病率和死亡率。接受大量液体复苏的重度烧伤患者发生这种情况的风险很高。对这些患者进行ACS的密切监测是必要的。持续的腹内压(IAP)超过20 mmHg且未缓解会导致较高的发病率和死亡率。测量IAP最广泛接受且可行的方法是通过标准导尿管的引流口。诗里拉吉烧伤中心用医院里容易找到的简单设备开发了自己的装置。事实证明,该装置在监测腹内压方面有用、便宜且有效。本研究描述了使用该装置监测和早期发现ACS的技术。对5例烧伤面积≥40%体表面积(TBSA)的重度烧伤患者,通过使用诗里拉吉装置经Foley导尿管测量IAP,并与经腹膜导管直接测量进行比较。两种方法测得的IAP无差异(p = 0.48)。这表明诗里拉吉装置导管有用、非侵入性且能有效反映实际的IAP。诗里拉吉烧伤中心建议对所有烧伤面积≥40% TBSA的重度烧伤患者进行IAP测量,以便早期识别和治疗可能导致ACS的腹腔内高压(IAH)。早期发现该综合征可能会减少腹压升高后导致器官功能障碍的不良影响。