Abdominal Compartment Syndrome Medication
- Author: Richard Paula, MD; Chief Editor: Rick Kulkarni, MD more...
Medication Summary
The goal of pharmacotherapy is to reduce intra-abdominal pressure. Diuretics are used for this purpose. However, pharmacologic therapy is less effective than mechanical drainage.
Diuretics
Class Summary
Diuretics decrease plasma volume and edema through diuresis.
Furosemide (Lasix)
Furosemide increases excretion of water by interfering with the chloride-binding cotransport system, which, in turn, inhibits sodium and chloride reabsorption in the ascending loop of Henle and distal renal tubule. The dose must be individualized. Depending on response, administer at increments of 20-40 mg no sooner than 6-8 h after previous dose, until desired diuresis occurs. When treating infants, titrate with 1-mg/kg/dose increments until satisfactory effect is achieved.
Spironolactone (Aldactone)
This agent is used for management of edema resulting from excessive aldosterone excretion. It competes with aldosterone for receptor sites in distal renal tubules, increasing water excretion while retaining potassium and hydrogen ions.
Amiloride
Amiloride is a pyrazine-carbonyl-guanidine unrelated chemically to other known antikaliuretic or diuretic agents. It is a potassium-conserving (antikaliuretic) drug that, compared with thiazide diuretics, possesses weak natriuretic, diuretic, and antihypertensive activity.
Simon RJ, Friedlander MH, Ivatury RR, et al. Hemorrhage lowers the threshold for intra-abdominal hypertension-induced pulmonary dysfunction. J Trauma. Mar 1997;42(3):398-403; discussion 404-5. [Medline].
Hobson KG, Young KM, Ciraulo A. Release of abdominal compartment syndrome improves survival in patients with burn injury. J Trauma. Dec 2002;53(6):1129-33; discussion 1133-4. [Medline].
Eddy V, Nunn C, Morris JA Jr. Abdominal compartment syndrome. The Nashville experience. Surg Clin North Am. Aug 1997;77(4):801-12. [Medline].
Malbrain ML, Chiumello D, Pelosi P, Bihari D, Innes R, Ranieri VM. Incidence and prognosis of intraabdominal hypertension in a mixed population of critically ill patients: a multiple-center epidemiological study. Crit Care Med. Feb 2005;33(2):315-22. [Medline].
Ivatury RR, Diebel L, Porter JM, Simon RJ. Intra-abdominal hypertension and the abdominal compartment syndrome. Surg Clin North Am. Aug 1997;77(4):783-800. [Medline].
Pickhardt PJ, Shimony JS, Heiken JP, et al. The abdominal compartment syndrome: CT findings. AJR Am J Roentgenol. Sep 1999;173(3):575-9. [Medline].
Burch JM, Moore EE, Moore FA, Franciose R. The abdominal compartment syndrome. Surg Clin North Am. Aug 1996;76(4):833-42. [Medline].
Cheatham ML, White MW, Sagraves SG, et al. Abdominal perfusion pressure: a superior parameter in the assessment of intra-abdominal hypertension. J Trauma. Oct 2000;49(4):621-6; discussion 626-7. [Medline].
Madigan MC, Kemp CD, Johnson JC, Cotton BA. Secondary abdominal compartment syndrome after severe extremity injury: are early, aggressive fluid resuscitation strategies to blame?. J Trauma. Feb 2008;64(2):280-5. [Medline].
Cheatham ML, Safcsak K. Is the evolving management of intra-abdominal hypertension and abdominal compartment syndrome improving survival?. Crit Care Med. Feb 2010;38(2):402-7. [Medline].
Chen RJ, Fang JF, Lin BC, Kao JL. Laparoscopic decompression of abdominal compartment syndrome after blunt hepatic trauma. Surg Endosc. Oct 2000;14(10):966. [Medline].
Agusti M, Elizalde JI, Adalia R. Dobutamine restores intestinal mucosal blood flow in a porcine model of intra-abdominal hyperpressure. Crit Care Med. Feb 2000;28(2):467-72. [Medline].
O'Mara MS, Slater H, Goldfarb IW, Caushaj PF. A prospective, randomized evaluation of intra-abdominal pressures with crystalloid and colloid resuscitation in burn patients. J Trauma. May 2005;58(5):1011-8. [Medline].
Oda J, Ueyama M, Yamashita K, Inoue T, Noborio M, Ode Y. Hypertonic lactated saline resuscitation reduces the risk of abdominal compartment syndrome in severely burned patients. J Trauma. Jan 2006;60(1):64-71. [Medline].
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