Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Intra-abdominal hypertension due to heparin induced retroperitoneal hematoma in patients with ventricle assist devices: report of four cases and review of the literature. | Daliakopoulos et al. Journal of Cardiothoracic Surgery 2010 5 108 http content 5 1 108 JOTS JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Intra-abdominal hypertension due to heparin -induced retroperitoneal hematoma in patients with ventricle assist devices report of four cases and review of the literature 1 1 2 11 Stavros I Daliakopoulos Manja Schaedel Michael N Klimatsidas Sotirios Spiliopoulos Reiner Koerfer Gero Tenderich1 Abstract Introduction Elevated intra-abdominal pressure IAP has been identified as a cascade of pathophysiologic changes leading in end-organ failure due to decreasing compliance of the abdomen and the development of abdomen compartment syndrome ACS . Spontaneous retroperitoneal hematoma SRH is a rare clinical entity seen almost exclusively in association with anticoagulation states coagulopathies and hemodialysis that may cause ACS among patients in the intensive care unit ICU and if treated inappropriately represents a high mortality rate. Case Presentation We report four patients a 36-year-old Caucasian female a 59-year-old White-Asian male a 64-year-old Caucasian female and a 61-year-old Caucasian female that developed an intra-abdominal hypertension due to heparin-induced retroperitoneal hematomas after implantation of ventricular assist devices because of heart failure. Three of the patients presented with dyspnea at rest fatigue pleura effusions in chest XR and increased heart rate although b-blocker therapy. A 36-year old female the forth patient presented with sudden severe shortness of breath at rest 10 days after an acute bronchitis . At the time of the event in all cases international normalized ratio INR was and partial thromboplastin time 65 sec. The patients were treated surgically the large hematomas were evacuated and the systemic manifestations of the syndrome were reversed. Conclusion Identifying patients in the ICU at risk for developing ACS with constant surveillance can lead
