Abdominal compartment syndrome: A review.
OBJECTIVE
The aims of this review were to summarize a) the consensus definitions of normal and pathologic intra-abdominal pressure (IAP); b) the techniques to measure IAP; c) the risk factors for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS); d) the pathophysiology of ACS; and e) the current recommendations for management and prevention of ACS.


METHODS
PubMed was searched using the following terms: ACS, IAH, IAP, and abdominal decompression.


RESULTS
ACS represents the natural progression of end-organ dysfunction caused by increased IAP and develops if IAH is not recognized and treated appropriately. Although the reported incidence of ACS is relatively low in critically ill children (0.6%-4.7%) it may be under-recognized and under-reported. The diagnosis of IAH/ACS depends on a high index of suspicion and the accurate and frequent measurement of IAP in patients at risk. Mortality from ACS remains high (50%-60%) even when decompression of the abdomen is performed early, which highlights the importance of detection and treatment of elevated IAP before end-organ damage occurs.


CONCLUSIONS
A widespread awareness of the recognition and current approach to management and prevention of IAH and ACS is needed among pediatric intensivists, so outcome of these life-threatening disease processes might be improved.
Carlotti
Ana P C P
AP
Department of Pediatrics (APCPC), Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. carlotti@fmrp.usp.br
Carvalho
Werther B
WB
D034841:Abdominal Cavity / Q000503:physiopathology*; D000007:Abdominal Injuries / Q000150:complications; D002648:Child; D002675:Child, Preschool; D003161:Compartment Syndromes / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000401:mortality / Q000628:therapy; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D004065:Digestive System Abnormalities / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000150:complications; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008365:Manometry / Q000379:methods; D009102:Multiple Organ Failure / Q000150:complications; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome