Volume -controlled peritoneal drainage for acute ascites resulted abdominal compartment syndrome

doi:10.3969/j.issn.1002-1949.2014.10.007

Abstract：Objective Intra -abdominal hypertension ( IAH ) has been identified as an independent risk factor for death .The primary goal of this study was to observe the effect of continuous volume -controlled percutaneous catheter drainage ( PCD ) for acute ascites resulted abdominal compartment syndrome ( ACS) .Methods We retrospectively analyzed the treatment effect of volume -controlled PCD in 12 patients with acute ascites resulted ACS from May 2011 to May 2013 in PICU. Eight patients who were treated without PCD were compared .Results Of these 12 enrolled children , 7 cases (7/12) were abdominal tumor rupture, 3 cases (3/12) were post -operation of liver or kidney transplantation and 2 cases ( 2/12 ) were urinary fistula resulted massive ascites . There were no significant differences in intra -abdominal pressure ( IAP ) , the numbers of organ dysfunction and PRISMⅢscores between two groups .Before PCD, the numbers of organ dysfunction were 2.3 ±0.8 in PCD group.Gastrointestinal tracts and pulmonary were the most frequently affected organs in ACS .High intra-abdominal pressure ( IAP ) was closely associated with multiple organ dysfunction and high mortality.PCD group had significantly lower mortality (PCD 3/12 vs non-PCD 8/8, P<0.001). However , we also found that as the complications of PCD , abdominal infection occurred once ( 1/12 ) and electrolyte imbalance ( 4/12 ) occurred occasionally . Conclusion Volume -controlled and continuous PCD , a minimally invasive decompression , is effective and safe in ACS patients with acute ascites.It can significantly reduce the number of organ dysfunction and the mortality of ACS which can help physician to gain more time for further original disease therapy .