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Intra-abdominal hypertension and the abdominal compartment syndrome
Abstract
The phenomenon of intra-abdominal hypertension (IAH) and its progression to abdominal compartment syndrome (ACS) is a common and frequently under-recognised condition in critically ill patients. IAH is defined as an intra-abdominal pressure (IAP) greater than 12 mmHg. The ACS occurs once IAH is associated with organ dysfunction. Early detection is the cornerstone of management in the critically ill patient and the regular measurement of IAP in patients at risk for developing raised IAP is encouraged. The intravesical technique of measurement is relatively non-invasive and provides excellent correlation with direct measurement of IAP. The consequences of ACS are multi-systemic, resulting in organ dysfunction. The respiratory, cardiovascular, renal and gastrointestinal systems are particularly affected. The vicious cycle of organ dysfunction may be perpetuated
by excessive fluid resuscitation. Early intervention is essential to prevent complications, which carry significant morbidity and, if untreated, possible mortality. Definitive management of this condition is the prompt surgical decompression of the abdomen followed by temporary abdominal closure.
Southern African Journal of Critical Care Vol. 23 (1) 2007: pp. 17-23
