Intra-abdominal pressure and abdominal compartment syndrome in acute general surgery.
BACKGROUND
Intra-abdominal pressure (IAP) is a harbinger of intra-abdominal mischief, and its measurement is cheap, simple to perform, and reproducible. Intra-abdominal hypertension (IAH), especially grades 3 and 4 (IAP > 18 mmHg), occurs in over a third of patients and is associated with an increase in intra-abdominal sepsis, bleeding, renal failure, and death.


METHODS
Increased IAP reading may provide an objective bedside stimulus for surgeons to expedite diagnostic and therapeutic work-up of critically ill patients. One of the greatest challenges surgeons and intensivists face worldwide is lack of recognition of the known association between IAH, ACS, and intra-abdominal sepsis. This lack of awareness of IAH and its progression to ACS may delay timely intervention and contribute to excessive patient resuscitation.


CONCLUSIONS
All patients entering the intensive care unit (ICU) after emergency general surgery or massive fluid resuscitation should have an IAP measurement performed every 6 h. Each ICU should have guidelines relating to techniques of IAP measurement and an algorithm for management of IAH.
Sugrue
Michael
M
Department of Surgery, Letterkenny General Hospital and Galway University Hospitals, Letterkenny, Donegal, Ireland. acstrauma@hotmail.com
Buhkari
Yasir
Y
D034841:Abdominal Cavity / Q000098:blood supply; D000208:Acute Disease; D003161:Compartment Syndromes / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D006874:Hydrostatic Pressure; D008991:Monitoring, Physiologic / Q000379:methods; D012307:Risk Factors