title: [Pathophysiological and clinical trials of the abdominal compartment syndrome].
abstract: The abdominal compartment syndrome (ACS) is defined a situation of high degrade abdominal hypertension (IAH) with clinicals signs of multiorganic dysfunction. It's observed like in the intensive care, in particular surgycals and postraumatics, there is ever a bigger frequence of complications presented by criticals patients. The various trials remark a changeable incidence, but the common factor is characterized by a particular severity of scores. All the possibles mechanicals, haemorragicals, infiammatories, and postraumatics causes act, but don't enable the stability among abdominal content, abdominal compliance and parietal tension. The initial triad of effects is constitued by the elevation of diaphragm and the visceral and vascular compression; after this triad provoke a pathophysiologic system that, through various levels, bring to a respiratory, renal and cardiocirculatory dysfunction and to a parietal, hepatic and intestinal ischemia with consequent bacterical translation: sepsis and MOF. The Burch's classification (1996) report four levels of gravity by the slight (< 15 mmHg) to the heavyest (> 35 mmHg): the firsts two levels are of intensivistic competence and for the detention are used conservatives metodics and pharmacological approach; instead in the lasts two levels it's necessary to foresee a surgycal treatment of laparotomy, washing and drainage with following temporary paret's closure. The mortality is now very elevated (29-62%) especially when it's already established a multiorganical dysfunction; therefore it's necessary forward its appearance through the monitorization of abdominal pression (IAP) with the measurement of vescical pression in alls criticals patients at the aim to treat immediately the firsts signs of IAH.
authors.affiliation: Università degli Studi "La Sapienza". I Facoltà di Medicina--Polo Pontino--UOC Universitario di Chirurgia Generale. franco.stagnitti@uniroma1.it
authors.forename: Franco
authors.initials: F
authors.lastname: Stagnitti
authors.forename: Stefano
authors.initials: S
authors.lastname: Toccaceli
authors.forename: Erasmo
authors.initials: E
authors.lastname: Spaziani
authors.forename: Giovanni Enrico
authors.initials: GE
authors.lastname: Casciaro
authors.forename: Francesco
authors.initials: F
authors.lastname: Priore
authors.forename: Pietro
authors.initials: P
authors.lastname: Gammardella
authors.forename: Sergio
authors.initials: S
authors.lastname: Corelli
authors.forename: Massimo
authors.initials: M
authors.lastname: Diana
authors.forename: Luigi Persico
authors.initials: LP
authors.lastname: Stella
authors.forename: Rossella
authors.initials: R
authors.lastname: Dandolo
authors.forename: Marcello
authors.initials: M
authors.lastname: De Pascalis
authors.forename: Alessandrra
authors.initials: A
authors.lastname: Martellucci
authors.forename: Alessandra
authors.initials: A
authors.lastname: Martellucci
mesh_terms: D034841:Abdominal Cavity / Q000503:physiopathology* / Q000601:surgery; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002986:Clinical Trials as Topic; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology* / Q000601:surgery; D009102:Multiple Organ Failure / Q000453:epidemiology