Intra-Abdominal Hypertension and Abdominal Compartment Syndrome: An Underappreciated Cause of Acute Kidney Injury.
Intra-abdominal hypertension (IAH) and abdominal compartment syndrome are increasingly recognized in both medical and surgical critically ill patients and are predictive of death and the development of acute kidney injury. Although there are many risk factors for the development of IAH, in the era of goal-directed therapy for shock, brisk volume resuscitation and volume overload are the most common contributors. Abdominal examination is an unreliable predictor of intra-abdominal pressure (IAP), but IAP can be easily measured in a reproducible and reliable manner by a number of simple bedside techniques. Prompt recognition and intervention to decrease IAP and improve vital organ perfusion are essential to minimize the negative effects of IAH on somatic and visceral organ functions.
Section of Critical Care Medicine, Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA; Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA; and Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA.
Deepa M
DM
Patel
Section of Critical Care Medicine, Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA; Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA; and Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA. Electronic address: michael.connor@emory.edu.
Michael J
MJ
Connor
D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016638:Critical Illness; D042241:Early Diagnosis; D061345:Early Medical Intervention; D005440:Fluid Therapy / Q000009:adverse effects; D006801:Humans; D007362:Intensive Care Units; D059325:Intra-Abdominal Hypertension / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D015995:Prevalence; D012079:Renal Circulation; D012151:Resuscitation; D012307:Risk Factors
Abdominal compartment syndrome; Abdominal perfusion pressure; Acute kidney injury (AKI); Intra-abdominal hypertension