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Abdominal compartment syndrome

Wolfgang Scheppach1

  • 1University of Wuerzburg, Germany; Department of Medicine (Gastroenterology/Rheumatology), Juliusspital Wuerzburg, Juliuspromenade 19, D-97070 Wuerzburg, Germany. w.scheppach@juliusspital.de

Best Practice & Research. Clinical Gastroenterology
|March 5, 2009
PubMed

Increased intra-abdominal pressure (IAP) has received growing attention in critically ill patients. Pathophysiologically, it deranges cardiovascular haemodynamics, respiratory and renal functions and may eventually lead to multi-organ failure. It is primarily seen in surgical intensive care units and is frequently associated with abdominal trauma but also occurs after elective abdominal surgery. Non-surgical intensivists ought to be aware that the syndrome is also seen in a wide spectrum of medical conditions, e.g. acute pancreatitis. An expert panel has recently set up definitions of intra-abdominal hypertension (IAH, sustained or repeated pathological elevation in IAP > or = 12 mmHg) and abdominal compartment syndrome (ACS, sustained IAP > 20 mmHg associated with a new organ dysfunction or failure). As clinical signs of IAH are unreliable, IAP should be measured non-invasively by the 'bladder technique'. It is hoped that the consensus definitions will contribute to a broader recognition and effective treatment of this life-threatening syndrome.

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