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British Journal of Anaesthesia, 1987, Vol. 59, No. 6 800-805
© 1987 The Board of Management and Trustees of the British Journal of Anaesthesia

case-report

HAEMODYNAMIC EFFECTS FOLLOWING SURGICAL RELEASE OF INCREASED INTRA-ABDOMINAL PRESSURE

M. P. SHELLY, F.F.A.R.C.S.*, A. A. ROBINSON, M.R.C.P., J. W. HESFORD, B.SC. and G. R. PARK, F.F.A.R.C.S.

The Intensive Care Unit, Addenbrooke's Hospital Hills Road, Cambridge CB2 2QQ.

*Present address: Royal United Hospitals, Coombe Park, Bath BA1 2NG.

Correspondence to G.R.P.

The haemodynamic indices of three patients, who developed abdominal tamponade as a result of intra-abdominal bleeding following liver transplantation, were measured on four occasions as the increased intra-abdominal pressure was released. Hypotension followed the release of the tamponade in all patients and was the result of a decrease in systemic vascular resistance. This was treated with vasoconstrictors; the response to various agents was monitored. Treatment of hypotension following release of abdominal tamponade by volume replacement alone may be inappropriate and may lead to over-transfusion; adrenaline may be the treatment of choice. Intensivemonitoring is advisable.


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