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Calculating Intraoperative Fluid Deficit to Prevent Abdominal Compartment Syndrome in Hip Arthroscopy
Journal article   Open access   Peer reviewed

Calculating Intraoperative Fluid Deficit to Prevent Abdominal Compartment Syndrome in Hip Arthroscopy

Dheeraj R. Yalamanchili, Stephen Shively, Michael B. Banffy, Neal Taliwal, Elliott Clark, Glen Hunter, Ashley Mayle, Guillaume D. Dumont, Robert W. Westermann, Joshua D. Harris, …
Arthroscopy techniques (Amsterdam), Vol.11(1), pp.E89-E93
01/01/2022
DOI: 10.1016/j.eats.2021.09.006
PMCID: PMC8807858
PMID: 35127433
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8807858View
Published (Version of record) Open Access

Abstract

Abdominal compartment syndrome (ACS) is a rare but potentially fatal complication that can occur during hip arthroscopy. This usually occurs as a result of arthroscopic fluid passing into the retroperitoneal space through the psoas tunnel. From the retroperitoneal space, the fluid can then enter the intraperitoneal space through defects in the peritoneum. Previous studies have identified female sex, iliopsoas tenotomy, pump pressure, and operative time as potential risk factors for fluid extravasation. We present a method to measure intraoperative fluid deficit during hip arthroscopy to alert surgeons to possible ACS. Our proposed technique requires diligent intraoperative monitoring of fluid output through various suction devices, including suction canisters, puddle vacuums, and suction mats. The difference is then calculated from the fluid intake from the arthroscopic fluid bags. If the difference is greater than 1500 mL, then the anesthesiologist and circulating nurse are instructed to examine the abdomen for distension every 15 minutes. This, combined with other common symptoms such as hypotension and hypothermia, should alert the surgical team to the development of ACS. Despite limitations to this technique, this approach offers an objective method to calculate intra-abdominal fluid extravasation.
Life Sciences & Biomedicine Orthopedics Science & Technology

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