Abdominal compartment syndrome contributing to failure of extracorporeal membrane oxygenation in an infant with congenital heart disease and sepsis.
OBJECTIVE
To provide the first account of extracorporeal membrane oxygenation therapy failure secondary to abdominal compartment syndrome.


METHODS
Case report.


METHODS
Pediatric intensive care unit.


METHODS
A 4-month-old infant with cyanotic congenital heart disease and Escherichia coli sepsis developed abdominal distention and venous return failure on extracorporeal membrane oxygenation.


METHODS
Emergency cardiac catheterization and atrial septectomy were performed.


RESULTS
Central venous pressure of 120 mm Hg was measured, confirming the diagnosis of abdominal compartment syndrome.


CONCLUSIONS
Abdominal compartment syndrome is a life-threatening condition resulting from an increase in intra-abdominal pressure that compromises abdominal organ perfusion, pulmonary function, and cardiac output. Mortality rates from abdominal compartment syndrome are as high as 60% in adults and children. This report of an infant with congenital heart disease and E. coli sepsis represents the first description of abdominal compartment syndrome that contributed to failure of extracorporeal membrane oxygenation and ultimately death. The pathophysiology, diagnosis, and treatment of abdominal compartment syndrome are also reviewed.
McKee
Christopher T
CT
Department of Anesthesiology and Critical Care, Johns Hopkins Medical Institute, Baltimore, MD, USA.
Vricella
Luca A
LA
Harris
Z Leah
ZL
Easley
R Blaine
RB
D000005:Abdomen; D003161:Compartment Syndromes / Q000150:complications* / Q000503:physiopathology; D004926:Escherichia coli; D015199:Extracorporeal Membrane Oxygenation; D017809:Fatal Outcome; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D018805:Sepsis / Q000150:complications*