title: Postinjury Primary Abdominal Compartment Syndrome.
abstract: Postinjury abdominal compartment syndrome (ACS) has evolved during the 1980s together with the introduction of damage control surgery (DCS) principles. DCS made it possible to salvage severely injured trauma patients who previously would have exsanguinated due to uncontrollable coagulopathic bleeding. These patients had severe hemorrhagic shock; their abdomens were tightly packed and had ongoing massive resuscitation. ACS is a lethal complication of the damage control patients. For today the pathophysiological characteristics of ACS are described, the intra-abdominal pressure is measured on many intensive care units. Postinjury ACS (primary and secondary) is one of the better characterized etiological types of ACS: risk factors, diagnostic criteria, independent predictors and preventive strategies are all well documented. Since the mortality of full-blown postinjury ACS is still unacceptably high and does not seem to improve with earlier decompression, prevention is the recommended strategy to decrease the morbidity and mortality. Open abdomen is one of the important preventive strategies but it is not free from morbidity and mortality. With aggressive open abdomen management in postinjury ACS these complications can be minimized. More importantly, timely hemorrhage control and hemostatic resuscitation are the likely solutions for more efficient prevention of the postinjury ACS.
authors.affiliation: Division of Surgery, Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, Australia. zsolt.balogh@hnehealth.nsw.gov.au.|Division of Surgery, Department of Traumatology, John Hunter Hospital and University of Newcastle, Locked Bag 1, Hunter Region Mail Center, Newcastle, NSW 2310, Australia. zsolt.balogh@hnehealth.nsw.gov.au.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Balogh
authors.affiliation: Division of Surgery, Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, Australia.
authors.forename: Cino
authors.initials: C
authors.lastname: Bendinelli
authors.affiliation: Division of Surgery, Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, Australia.
authors.forename: Timothy
authors.initials: T
authors.lastname: Pollitt
authors.affiliation: Department of Surgery, Memorial Hermann Hospital, UT-Houston Medical School, Texas Medical Center, Houston, TX, USA.
authors.forename: Rosemary A
authors.initials: RA
authors.lastname: Kozar
authors.affiliation: Department of Surgery, Methodist Hospital, Texas Medical Center, Houston, TX, USA.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Moore
keywords: Abdominal; Abdominal compartment syndrome (ACS); Damage control surgery (DCS)