A massive fluid therapy could be damaging for the patient.
She suffered massive fluid loss leading to shock and organ failure.
Secondary ACS has an extra-abdominal cause such as massive fluid resuscitation leading to intestinal and mesenteric edema [2].
On DOL 5, the patient became progressively hypoxemic and hypotensive with worsening lactic acidosis refractory to massive fluid resuscitation and inotropic support, suggesting fungal septic shock.
In association with massive fluid resuscitation, the acute intestinal permeability syndrome, which is part of global capillary leak, may lead to multi-organ failure [33].
Parker et al. suggested that "massive" fluid infusion maintains a normal cardiac index, despite a significantly impaired LV contractility, through LV preload adaptation [1].
Prior studies have shown that risk factors for the development of IAH and ACS include acute respiratory failure, abdominal surgery, sepsis, massive fluid resuscitation, and major trauma [6].
For patients admitted to the ICU, we collected performed invasive procedures, mechanical ventilation, vasoactive drugs administration, massive fluid resuscitation (defined as greater than half of an estimated body blood volume) and renal replacement therapy.
Management mainly consisted in the administration of adequate supportive care: massive fluid repletion (60%), mechanical ventilation (55%; duration: 1 day [1; 4]), sedative drugs (50%), external cooling (40%), catecholamines (35%), defibrillation (20%), massive transfusions (20%) and arterio-venous ECMO (20%).
A MRI of her lumboscaral spine was performed in 2011 with showed a massive fluid filled structure in the pelvis and a diagnosis of a giant dural ectasia or anterior sacral meningocele was made.
IAH is caused by additional intra-abdominal volume (IAV) within the confined abdominal cavity (e.g., retroperitoneal bleed, free fluid from massive fluid resuscitation, ascites, ileus with dilated bowel, etc).
