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6.Abdominal Compartment Syndrome

6.Abdominal Compartment Syndrome

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Published by Dr.G.Bhanu Prakash
www.gims-org.com
www.gims-org.com

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Published by: Dr.G.Bhanu Prakash on Aug 30, 2010
Copyright:Attribution Non-commercial

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06/16/2012

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ABDOMINAL COMPARTMENTSYNDROME
Symptomatic organ dysfunction that results from increased intraabdominalpressure (IAP)
Increased IAP is an under-recognized source of morbidity and mortality.
1-day point-prevalence observational trial conducted in 13 medical ICUs of sixcountries with 97 patients, 8% had IAP > 20mmHg.
1
The incidence of ACS in trauma patients is estimated to be between 2 and 9percent.
2
www.gims-org.com
 
ABDOMINAL COMPARTMENT SYNDROME
Massive volume resuscitation in the leading cause of ACS.
Inflammatory states with capillary leak, fluid sequestration, inadequate tissueperfusion, and lactic acidosis can develop ACS.
Gastric overdistention following endoscopy has resulted in ACS.
ETIOLOGY
 
ABDOMINAL COMPARTMENT SYNDROME
The IAP is usually 0 mmHg during spontaneous respiration, and is slightlypositive in the patient on mechanical ventilation.
IAP increases in direct relation to body mass index, and in one report, supinehospitalized patients had a mean baseline value of 6.5 mmHg.
The compliance of the abdominal wall generally limits the rise in IAP butincreases rapidly after a critical IAP.
Critical IAP varies from patient to patient, based on abdominal wall complianceon perfusion gradient.
IAH often defined as IAP > 12mmHg.
Previous pregnancy, cirrhosis, morbid obesity, may increase abdominal wallcompliance and can be protective .
PATHOPHYSIOLOGY

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