The relationship between fluid resuscitation and intra-abdominal hypertension in patients with blunt abdominal trauma.

BACKGROUND: Excessive fluid administration for saving patients from hypovolemic shocks is one of the main causes of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). The purpose of this paper is to survey the relationship between fluid resuscitation and increase intra-abdominal pressure (IAP).

MATERIALS AND METHODS: The present descriptive-analytical study recruited 100 patients with confirmed abdominal trauma and presenting to emergency departments. The cases with high IAP measured through the bladder were identified as developing ACS in case of having comorbidities involving two of the following systems: respiratory system, renal system or cardiovascular system. The volume of the fluids administered was compared in the first 24 h in subjects with and without ACS.

RESULTS: Of 100 patients with abdominal trauma, whose IAP was measured, 28 cases developed ACS. The mean volume of the fluids received was found to be significantly higher in the patients with ACS (8772 ml) compared to in those without (5404 ml). As a complication of excessive fluid administration, IAH can seriously threaten the patient's life.

CONCLUSIONS: Excessive fluid resuscitation causes ACS among the critically ill or injured patients such as abdominal trauma, pelvic fracture and intra-abdominal organ injuries hence to prevent this complication in all patients requiring short-term excessive administration of fluids, great care, and sensitivity are required to constantly control IAP and adjust the fluid administration.