title: Influence of abdominal pressure on respiratory and abdominal organ function.
abstract: OBJECTIVE
  Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have been realized as severe complications in the intensive care patient. Laparoscopic surgery in older and more obese patients increases the risk of IAH and ACS.
  
  
  RESULTS
  The incidence of IAH may be larger than thought of being approximately one-third of mechanically ventilated intensive care patients. In shock/trauma, three-fourths of all patients may suffer from IAH. Kidney and liver may dysfunction and the gut barrier may be impeded, permitting spread of inflammation to other organs. IAH and ACS have an impact on respiratory mechanics and may impede ventilation and require higher ventilation pressures than under normal conditions. Prone position and alternating (asynchronous) ventilation may moderate the IAH. In addition, surgical decompression should be considered.
  
  
  CONCLUSIONS
  In view of the frequent occurrence of IAH in intensive care, the need of better understanding of the mechanisms behind IAH is a prerequisite for better treatment. Respiratory mechanics are affected but may also indicate routes of ventilatory treatment to lower IAH.
authors.affiliation: Department of Clinical Physiology, Uppsala University, Uppsala, Sweden. goran.hedenstierna@akademiska.se
authors.forename: Göran
authors.initials: G
authors.lastname: Hedenstierna
authors.forename: Anders
authors.initials: A
authors.lastname: Larsson
mesh_terms: D034841:Abdominal Cavity / Q000503:physiopathology* / Q000601:surgery; D003161:Compartment Syndromes / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D003422:Critical Care; D019299:Decompression, Surgical; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D010535:Laparoscopy / Q000009:adverse effects*; D009102:Multiple Organ Failure / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D009765:Obesity / Q000150:complications; D011312:Pressure