Fluid Management, Intra-Abdominal Hypertension and the Abdominal Compartment Syndrome: A Narrative Review
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
Affiliations
Rita Jacobs
Intensive Care Department, Antwerp University Hospital, 2650 Edegem, Belgium
Robert D. Wise
Faculty Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium
Ivan Myatchin
Intensive Care Department, University Hospital Brussels, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
Domien Vanhonacker
Intensive Care Department, University Hospital Brussels, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
Andrea Minini
Intensive Care Department, University Hospital Brussels, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
Michael Mekeirele
Intensive Care Department, University Hospital Brussels, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
Andrew W. Kirkpatrick
Departments of Critical Care Medicine and Surgery, The Trauma Program, University of Calgary, Victoria, BC V8W 2Y2, Canada
Bruno M. Pereira
Department of Surgery, Health Applied Sciences, Vassouras University, Vassouras 27700, Brazil
Michael Sugrue
Donegal Clinical Research Academy and Emergency Surgery Outcome Advancement Project (eSOAP), F94 A0W2 Donegal, Ireland
Bart De Keulenaer
Department of Intensive Care, Fiona Stanley Hospital; Professor at the School of Surgery, The University of Western Australia, Perth, WA 6907, Australia
Zsolt Bodnar
Consultant General Surgeon, Letterkenny University Hospital, F92 AE81 Letterkenny, Ireland
Stefan Acosta
Department of Clinical Sciences, Lund University, Box 117, SE-221 00 Lund, Sweden
Janeth Ejike
Department of Pediatrics, Loma Linda University Children’s Hospital, Loma Linda, CA 92354, USA
Salar Tayebi
Faculty of Engineering, Department of Electronics and Informatics, Vrije Universiteit Brussel (VUB), 1040 Etterbeek, Belgium
Johan Stiens
Faculty of Engineering, Department of Electronics and Informatics, Vrije Universiteit Brussel (VUB), 1040 Etterbeek, Belgium
Colin Cordemans
Department of Intensive Care, AZ Sint-Maria Hospital, 1500 Halle, Belgium
Niels Van Regenmortel
Intensive Care Department, Antwerp University Hospital, 2650 Edegem, Belgium
Paul W. G. Elbers
Department of Intensive Care Medicine, Laboratory for Critical Care Computational Intelligence, Amsterdam Medical Data Science (AMDS), Amsterdam UMC, Vrije Universiteit, 1081 Amsterdam, The Netherlands
Xavier Monnet
Groupe de Recherche Clinique CARMAS, Université Paris-Saclay, Service de Médecine Intensive-Réanimation, Hôpital de Bicêtre, FHU SEPSIS, 94275 Le Kremlin-Bicêtre, France
Adrian Wong
Faculty Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium
Wojciech Dabrowski
First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland
Philippe G. Jorens
Intensive Care Department, Antwerp University Hospital, 2650 Edegem, Belgium
Jan J. De Waele
Intensive Care Unit, University Hospital Ghent, 9000 Ghent, Belgium
Derek J. Roberts
Division of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 1H3, Canada
Edward Kimball
Department of Surgery and Critical Care, U Health OND&T, Salt Lake City, UT 84105, USA
Annika Reintam Blaser
Department of Anesthesiology and Intensive Care, University of Tartu, 50090 Tartu, Estonia
Manu L. N. G. Malbrain
First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland
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.
