• Ismail Mahmood, Saeed Mahmood, Ashok Parchani, Suresh Kumar, Ayman El-Menyar, Ahmad Zarour, Hassan Al-Thani, and Rifat Latifi.
• Trauma Intensive Care Unit, Section of Trauma Surgery, Department of Surgery, Hamad General Hospital, Doha, Qatar.
• ANZ J Surg. 2014 Mar 1;84(3):166-71.

BackgroundThis study aimed to determine the incidence and outcome of post-traumatic (PT) intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) after the advances in haemostatic resuscitation.MethodsThis is a prospective cohort study from January 2009-December 2011 involving patients with PT haemorrhagic shock. Patients' demographics, fluid resuscitation (<24 h) and damage control laparotomy (DCL), morbidity and mortality were assessed. Patients were divided into group 1 (no DCL) and group 2 (DCL needed). Further, group 1 was subdivided into three subgroups (IA pressure (IAP) <12, 12-20 and >20 mmHg).ResultsOne hundred seventeen patients enrolled in the study (102 in group 1 and 15 in group 2) with a mean age of 35 ± 14, injury severity score (ISS) of 23 ± 10, base deficit of -8.7 ± 2.7 mmol/L, serum lactate of 4.6 ± 2.5 mg/dL and haemoglobin level of 8.8 ± 2. Patients received 7 ± 5 red blood cell units, 6 ± 4.7 fresh frozen plasma units and 8.3 ± 3 L of crystalloid per 24 h. There were significant difference between the two groups regarding crystalloid volume, blood transfusion, base deficit and intensive care unit length of stay. However, mortality was higher in group 2 (20% versus 6%). IAP ≥ 20 mmHg was reported in 16.7% patients, while 25.5% had IAP < 12 and 57.8% had IAP of 12-20 mmHg. Patients with IAP > 20 had worse metabolic acidosis and received more blood compared with other groups. One patient died because of ACS (0.9%). Overall multiorgan failure and mortality were 5 and 7.7%, respectively.ConclusionWith current practice of minimal fluid resuscitation and liberal use of damage control strategies among trauma patients, the IAH was common transient phenomena but the incidence of ACS is remarkably low.© 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

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