A 55-year-old male is brought to the intensive care unit (ICU) after an exploratory laparotomy because of a motor vehicle collision where he suffered a liver laceration. He is intubated with an open abdomen and a negative pressure abdominal wound dressing. He remains hypotensive on norepinephrine infusion of 1 µg/kg/min and was transfused 16 units of packed RBCs, 8 units of fresh frozen plasma, 8 packs of platelets, 2 bags of cryoprecipitate. Repeat laboratory tests show a stable hemoglobin postoperatively. However, his urine output starts to decline, and his pressor requirements start to rise. On examination, the abdomen is distended and tight. In the case of intra-abdominal hypertension (IAH), what is the minimum ideal abdominal perfusion pressure (APP) correlating to improved survival?
A. 90 mm Hg Wrong Choice!
B. 80 mm Hg Wrong Choice!
C. 70 mm Hg Wrong Choice!
D. 60 mm Hg Correct Choice
Answer:D
A 55-year-old male is brought to the intensive care unit (ICU) after an exploratory laparotomy because of a motor vehicle collision where he suffered a liver laceration. He is intubated with an open abdomen and a negative pressure abdominal wound dressing. He remains hypotensive on norepinephrine infusion of 1 µg/kg/min and was transfused 16 units of packed RBCs, 8 units of fresh frozen plasma, 8 packs of platelets, 2 bags of cryoprecipitate. Repeat laboratory tests show a stable hemoglobin postoperatively. However, his urine output starts to decline, and his pressor requirements start to rise. On examination, the abdomen is distended and tight. In the case of intra-abdominal hypertension (IAH), what is the minimum ideal abdominal perfusion pressure (APP) correlating to improved survival?
A. 90 mm Hg Wrong Choice! B. 80 mm Hg Wrong Choice! C. 70 mm Hg Wrong Choice! D. 60 mm Hg Correct Choice