Perioperative treatment of a patient with abdominal compartment syndrome due to neuroblastoma and hepatomegaly

A male infant developed abdominal compartment syndrome (ACS) due to stage-4S neuroblastoma and hepatic enlargement. Because of tumor lysis syndrome by chemotherapy and radiationtherapy, his condition deteriorated and he underwent emergent abdominal counterincision surgical operation in the intensive care unit. General anesthesia was maintained with O₂ (100%), midazolam (0.25-0.3 mg·kg^-1·hr^-1), fentanyl, and rocuronium infusion. By removal of the ACS, the breathing improved. At the end of the operation, we inserted GamCath catheter from his internal jugular vein for CHDF performed after the operation. We used midazolam, fentanyl and rocuronium for sedation. Subsequently, 8 days later, his general condition markedly improved, and we could evade performing CHDF.