• Tim R Glowka, Jens-Christian Schewe, Stefan Muenster, Christian Putensen, Jörg C Kalff, and Dimitrios Pantelis.
• Department of Surgery, University of Bonn, Bonn, Germany. Electronic address: tim.glowka@ukbonn.de.
• J Crit Care. 2018 Oct 1; 47: 274-279.

PurposeExtracorporeal membrane oxygenation (ECMO) is increasingly used with various indications. The clinical course can be complicated by an abdominal compartment syndrome (ACS). A decompressive laparotomy (DL) can be an option.Materials And MethodsBetween 2014 and 2016 175 patients underwent ECMO support. Indications, demographic data, comorbidities, morbidity, mortality and length of stay were analyzed.ResultsIndications for ECMO were acute respiratory distress syndrome (n = 65), postpericardiotomy syndrome (n = 37), myocardial infarction (n = 26), extracorporeal cardiopulmonary resuscitation (n = 11), and others (n = 36). ECMO support was performed as veno-venous (VV, n = 91) or veno-arterial (VA, n = 84). Eleven patients developed ACS (VV-ECMO: n = 4; VA-ECMO: n = 7) and underwent DL. Three patients survived to hospital discharge. Risk factors were age (57 vs. 60.5 years, P = 0.032), a Charlson comorbidity index >1 (CCI, P = 0.004), a Simplified Acute Physiology Score (SAPS II) ≥ 42 at admission to ICU (P = 0.013) and ≥44 at the beginning of ECMO support (P = 0.004). When an ACS/DL occurred, mortality did not differ (DL: n = 11; 73% vs. no DL: n = 164; 65%; P = 0.749). Multivarate analysis revealed CCI and SAPS as independent predictors for mortality.ConclusionsApproximately 10% of patients undergoing VA-ECMO support developed an ACS. If DL is undertaken, SAPS II scores can be used as predictive factor for mortality.

28 keywords...

hide…