title: Increased pressure within the abdominal compartment: intra-abdominal hypertension and the abdominal compartment syndrome.
abstract: OBJECTIVE
  This article reviews recent developments related to intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS) and clinical practice guidelines published in 2013.
  
  
  RESULTS
  IAH/ACS often develops because of the acute intestinal distress syndrome. Although the incidence of postinjury ACS is decreasing, IAH remains common and associated with significant morbidity and mortality among critically ill/injured patients. Many risk factors for IAH include those findings suggested to be indications for use of damage control surgery in trauma patients. Medical management strategies for IAH/ACS include sedation/analgesia, neuromuscular blocking and prokinetic agents, enteral decompression tubes, interventions that decrease fluid balance, and percutaneous catheter drainage. IAH/ACS may be prevented in patients undergoing laparotomy by leaving the abdomen open where appropriate. If ACS cannot be prevented with medical or surgical management strategies or treated with percutaneous catheter drainage, guidelines recommend urgent decompressive laparotomy. Use of negative pressure peritoneal therapy for temporary closure of the open abdomen may improve the systemic inflammatory response and patient-important outcomes.
  
  
  CONCLUSIONS
  In the last 15 years, investigators have better clarified the pathogenesis, epidemiology, diagnosis, and appropriate prevention of IAH/ACS. Subsequent study should be aimed at understanding which treatments effectively lower intra-abdominal pressure and whether these treatments ultimately affect patient-important outcomes.
authors: aDepartment of Surgery bRegional Trauma Program cDepartment of Oncology dDepartment of Critical Care Medicine, University of Calgary and the Foothills Medical Centre, Calgary, Alberta, Canada.
authors: Derek J
authors: DJ
authors: Roberts
authors: Chad G
authors: CG
authors: Ball
authors: Andrew W
authors: AW
authors: Kirkpatrick
mesh_terms: D034841:Abdominal Cavity / Q000503:physiopathology*; D016638:Critical Illness; D019299:Decompression, Surgical / Q000379:methods*; D006801:Humans; D015994:Incidence; D059325:Intra-Abdominal Hypertension / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D016896:Treatment Outcome