[Abdominal compartment syndrome. A still underestimated problem?].

Area of Science:

• Critical care medicine
• Surgical critical care
• Abdominal surgery

Context:

• Abdominal compartment syndrome (ACS) is a life-threatening condition in critically ill patients.
• It is characterized by increased intra-abdominal pressure (IAP) leading to organ dysfunction.
• Risk factors include pelvic trauma, massive fluid resuscitation, aortic aneurysm repair, and increased BMI.

Purpose:

• To highlight the causes, indicators, and consequences of ACS.
• To emphasize the diagnostic challenges and the importance of early recognition.
• To underscore the critical role of timely surgical intervention in managing ACS.

Summary:

• ACS results from elevated IAP (>12 mm Hg), causing ischemia and necrosis of intra- and extra-abdominal organs.
• Indicators include increased airway pressures, hypoxia, oliguria, shock, and acidosis.
• Repetitive intravesical pressure measurements (>20 mm Hg) aid in early diagnosis of intra-abdominal hypertension.

Impact:

• ACS leads to multi-organ failure with a mortality rate of 60-70%.
• Early diagnosis and intensive care, including mechanical ventilation and circulatory support, are crucial.
• Prompt abdominal decompression and open abdominal treatment are life-saving interventions that prevent further organ damage.