Prevalence of abdominal compartment syndrome and effect of decompressive laparotomy in patients requiring ECMO

<bold>Aim:</bold> To investigate the prevalence of abdominal compartment syndrome (ACS) in patients requiring ECMO and to assess the effect of decompressive laparotomy (DL) on respiratory and circulatory function. <bold>Methods:</bold> Retrospective observational study of adult patients requiring ECMO between 01/2010 to 06/2020 at the University Medical Center Regensburg. Patients with clinically suspected ACS were screened by measuring intra-abdominal pressure (IAP) with trans-bladder technique. ACS was defined as IAP >20mmHg with new organ dysfunction, survival as alive hospital discharge. <bold>Results:</bold> The prevalence of ACS was 2.3% (16/699), 3.3% (31/944) and 4.2% (32/766) in patients receiving veno-venous, veno-arterial ECMO or in resuscitated ECMO patients. DL improved minute ventilation, IAP, vasopressors, and lactate (Figure 1). Survival was comparable between the DL and the non-DL group (27% vs. 33%, p=0.633; Figure 2). <bold>Conclusion:</bold> The prevalence of ACS in patients requiring ECMO was up to 4.2%. In ECMO patients with high IAP and ventilatory impairment, DL might lead to improved respiratory and circulatory function. Figure 1: <fig><object-id>erj;64/suppl_68/PA2619/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> Figure 2: <fig><object-id>erj;64/suppl_68/PA2619/F2</object-id><object-id>F2</object-id><object-id>F2</object-id><graphic></graphic></fig>