Lethal abdominal compartment syndrome after extracorporeal cardiopulmonary resuscitation in a patient with out-of-hospital cardiac arrest: a case report

Gun Jik Kim, Kyoung Hoon Lim, Tak hyuk Oh, Hyun Joo Lee, Deokbi Hwang, Hanna Jung

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Clinical attempts of extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) have increased in recent years; however, it also has life-threatening complications. Massive fluid and transfusion resuscitation, shock status, or low cardiac output status during ECPR may lead to ascites and interstitial edema, resulting in secondary abdominal compartment syndrome (ACS). Case presentation: A 43-year-old male patient was admitted to the emergency department due to cardiac arrest. Due to refractory ventricular fibrillation, ECPR was initiated. Approximately, 3 h after extracorporeal membrane oxygenation support, abdominal distension and rigidity developed. Therefore, ACS was suspected. Decompression laparotomy was required to relieve elevated intra-abdominal pressure. Conclusions: We report a case of a patient with OHCA who developed lethal ACS after ECPR. Despite this, the patient was able to recover from several major crises. Regardless of how lethal the patient is, if compartment syndrome develops in any part of the body, we should aggressively consider surgical decompression.

Original languageEnglish
Article number61
JournalInternational Journal of Emergency Medicine
Volume16
Issue number1
DOIs
StatePublished - Dec 2023

Keywords

  • Cardiopulmonary resuscitation
  • Compartment Syndromes
  • Extracorporeal membrane oxygenation
  • Fasciotomy
  • Intensive care units
  • Laparotomy
  • Out-of-hospital cardiac arrest

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