Abdominal compartment syndrome.
Increased intra-abdominal pressure (IAP) has received growing attention in critically ill patients. Pathophysiologically, it deranges cardiovascular haemodynamics, respiratory and renal functions and may eventually lead to multi-organ failure. It is primarily seen in surgical intensive care units and is frequently associated with abdominal trauma but also occurs after elective abdominal surgery. Non-surgical intensivists ought to be aware that the syndrome is also seen in a wide spectrum of medical conditions, e.g. acute pancreatitis. An expert panel has recently set up definitions of intra-abdominal hypertension (IAH, sustained or repeated pathological elevation in IAP > or = 12 mmHg) and abdominal compartment syndrome (ACS, sustained IAP > 20 mmHg associated with a new organ dysfunction or failure). As clinical signs of IAH are unreliable, IAP should be measured non-invasively by the 'bladder technique'. It is hoped that the consensus definitions will contribute to a broader recognition and effective treatment of this life-threatening syndrome.
Scheppach
Wolfgang
W
University of Wuerzburg, Germany; Department of Medicine (Gastroenterology/Rheumatology), Juliusspital Wuerzburg, Juliuspromenade 19, D-97070 Wuerzburg, Germany. w.scheppach@juliusspital.de
D000005:Abdomen / Q000503:physiopathology* / Q000601:surgery; D000007:Abdominal Injuries / Q000150:complications; D003161:Compartment Syndromes / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D005440:Fluid Therapy / Q000009:adverse effects; D006801:Humans; D008365:Manometry; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011312:Pressure; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D009626:Terminology as Topic