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Acute transfusion-related abdominal injury in trauma patients: a case report

Overview of attention for article published in Journal of Medical Case Reports, October 2016
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Title
Acute transfusion-related abdominal injury in trauma patients: a case report
Published in
Journal of Medical Case Reports, October 2016
DOI 10.1186/s13256-016-1075-4
Pubmed ID
Authors

P. Michel, D. Wähnert, M. Freistühler, M. G. Laukoetter, S. Rehberg, M. J. Raschke, P. Garcia

Abstract

Secondary abdominal compartment syndrome is well known as a life-threatening complication in critically ill patients in an intensive care unit. Massive crystalloid fluid resuscitation has been identified as the most important risk factor. The time interval from hospital admittance to the development of manifest abdominal compartment syndrome is usually greater than 24 hours. In the absence of any direct abdominal trauma, we observed a rapidly evolving secondary abdominal compartment syndrome shortly after hospital admittance associated with massive transfusion of blood products and only moderate crystalloid resuscitation. We report the case of an acute secondary abdominal compartment syndrome developing within 3 to 4 hours in a 74-year-old polytraumatized white woman. Although multiple fractures of her extremities and a B-type pelvic ring fracture were diagnosed by a full body computed tomography scan, no intra-abdominal injury could be detected. Hemorrhagic shock with a drop in her hemoglobin level to 5.7 g/dl was treated by massive transfusion of blood products and high doses of catecholamines. Shortly afterwards, her pulmonary gas exchange progressively deteriorated and mechanical ventilation became almost impossible with peak airway pressures of up to 60 cmH2O. Her abdomen appeared rigid and tense accompanied by a progressive hemodynamic decompensation necessitating mechanic cardiopulmonary resuscitation. Although preoperative computed tomography scans showed no signs of intra-abdominal fluid, a decompressive laparotomy under cardiopulmonary resuscitation conditions was performed and 2 liters of ascites-like fluid disgorged. Her hemodynamics and pulmonary ventilation improved immediately. This case report describes for the first time acute secondary abdominal compartment syndrome in a trauma patient, evolving in a very short time period. We hypothesize that the massive transfusion of blood products along with high doses of catecholamines triggered the acute development of abdominal compartment syndrome. Trauma teams need to consider a rapidly developing secondary abdominal compartment syndrome to be a potential cause of hemodynamic decompensation not only in the later phase of treatment but also in the emergency phase of treatment.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 32 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 32 100%

Demographic breakdown

Readers by professional status Count As %
Other 5 16%
Student > Master 5 16%
Student > Bachelor 3 9%
Student > Doctoral Student 2 6%
Researcher 2 6%
Other 7 22%
Unknown 8 25%
Readers by discipline Count As %
Medicine and Dentistry 19 59%
Engineering 2 6%
Biochemistry, Genetics and Molecular Biology 1 3%
Design 1 3%
Unknown 9 28%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 October 2016.
All research outputs
#9,071,170
of 11,329,665 outputs
Outputs from Journal of Medical Case Reports
#938
of 1,684 outputs
Outputs of similar age
#178,249
of 255,726 outputs
Outputs of similar age from Journal of Medical Case Reports
#45
of 110 outputs
Altmetric has tracked 11,329,665 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,684 research outputs from this source. They receive a mean Attention Score of 3.4. This one is in the 16th percentile – i.e., 16% of its peers scored the same or lower than it.
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We're also able to compare this research output to 110 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.