Temporary abdominal closure: A prospective evaluation of its effects on renal and respiratory physiology

Michael Sugrue*, Felicity Jones, Khan Jahangir Janjua, Stephen A. Deane, Peter Bristow, Ken Hillman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

72 Citations (Scopus)

Abstract

This study prospectively analyzed outcomes in 49 consecutive patients undergoing temporary abdominal closure (TAC) between 1993 and 1996 at a single university hospital. There were 37 males and 12 females, mean age was 57 years (range, 25-79 years), mean Acute Physiology and Chronic Health Evaluation score was 27 (±7.8 SD), and mean Simplified Acute Physiology II score was 53.0 (±15.4). The reason for TAC was decompression in 22 patients, inability to close the abdomen in 10 patients, to facilitate reexploration for sepsis in 8 patients, and multifactorial in 9 patients. After TAC, there was a significant reduction in intra-abdominal pressure from 24.2 ± 9.3 to 14.1 ± 5.5 mm Hg and improvement in lung dynamic compliance from 24.1 ± 7.9 to 27.6 ± 9.4 mL/cm H2O (p < 0.05). Although 10 patients experienced brisk diuresis, there was no significant improvement in renal function; in fact, serum creatinine increased. The median length of stay was 35 days (range, 1- 232 days). The mean number of abdominal operations after mesh insertion was 2.6 ± 2.4. There were 21 deaths, for a standardized mortality rate of 0.80. Although it achieved significant reductions in abdominal pressures and improved lung dynamic compliance, TAC did not result in improved renal function or patient oxygenation.

Original languageEnglish
Pages (from-to)914-921
Number of pages8
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume45
Issue number5
Publication statusPublished - Nov 1998
Externally publishedYes

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