Raghav Chandra1, Richard A Jacobson2, Jennifer Poirier3, Keith Millikan4, Emilie Robinson5, Nicole Siparsky6. 1. Department of Surgery, Rush Medical College, 1725 W. Harrison St., Suite 810/818, Chicago, IL, USA. Electronic address: Raghav_Chandra@rush.edu. 2. Department of Surgery, Rush Medical College, 1725 W. Harrison St., Suite 810/818, Chicago, IL, USA. Electronic address: Richard_A_Jacobson@rush.edu. 3. Department of Surgery, Rush Medical College, 1725 W. Harrison St., Suite 810/818, Chicago, IL, USA. Electronic address: Jennifer_Poirier@rush.edu. 4. Department of Surgery, Rush Medical College, 1725 W. Harrison St., Suite 810/818, Chicago, IL, USA. Electronic address: Keith_W_Millikan@rush.edu. 5. Department of Surgery, Rush Medical College, 1725 W. Harrison St., Suite 810/818, Chicago, IL, USA. Electronic address: Emilie_C_Robinson@rush.edu. 6. Department of Surgery, Rush Medical College, 1725 W. Harrison St., Suite 810/818, Chicago, IL, USA. Electronic address: Nicole_Siparsky@rush.edu.
Abstract
BACKGROUND: Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are devastating complications of surgery. Patients who undergo complex ventral hernia repair (CVHR) may be at risk for IAH and ACS. METHODS: We performed a retrospective review of 175 patients who underwent CVHR by a single surgeon. Body mass index (BMI), prior hernia repair, operative time, bladder pressure, serum creatinine, sedation, paralytic therapy, and ventilator support were reviewed. RESULTS: IAH was identified in 33 patients; 11 patients developed ACS. Paralytic therapy was employed in 29 patients for an average of 1.4 days. Elevated BMI was independently associated with an increased risk of IAH (p = 0.006) and ACS (p = 0.02). CONCLUSION: Patients who undergo CVHR are at risk of developing IAH and ACS in the postoperative period. Elevated BMI and longer operative time are independent risk factors for the development of IAH. IAH and ACS can be successfully managed with surgical critical care.
BACKGROUND:Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are devastating complications of surgery. Patients who undergo complex ventral hernia repair (CVHR) may be at risk for IAH and ACS. METHODS: We performed a retrospective review of 175 patients who underwent CVHR by a single surgeon. Body mass index (BMI), prior hernia repair, operative time, bladder pressure, serum creatinine, sedation, paralytic therapy, and ventilator support were reviewed. RESULTS: IAH was identified in 33 patients; 11 patients developed ACS. Paralytic therapy was employed in 29 patients for an average of 1.4 days. Elevated BMI was independently associated with an increased risk of IAH (p = 0.006) and ACS (p = 0.02). CONCLUSION:Patients who undergo CVHR are at risk of developing IAH and ACS in the postoperative period. Elevated BMI and longer operative time are independent risk factors for the development of IAH. IAH and ACS can be successfully managed with surgical critical care.