Racial and Ethnic Disparities in Pediatric Congenital Heart Disease

This trauma patient with an open abdomen that has been packed is at risk for abdominal compartment syndrome. Risk factors for the development of abdominal compartment syndrome include high dose vasopressor and fluid requirement, abdominal packing, and visceral or vascular abdominal injuries. Presentation includes hypotension due to decreased venous return from the increased intra-abdominal pressure as well as hypoxia due to increased airway pressures. Measuring bladder pressure can help to determine if there is elevated intra-abdominal pressure. Patients with intra-abdominal pressures between 25-35 mmHg will likely require an urgent decompression, while patients with intra-abdominal pressures greater than 35 mmHg require emergent decompression in order to prevent cardiovascular collapse. Decompression includes opening the temporary closure and removing the packing followed by placement of a temporary abdominal closure with sterile mesh or plastic bags to allow for expansion.