Abdominal Compartment Syndrome In Critically Ill Patients

Abstract

In the last decade, an exponential increase in intraabdominal hypertension (IAH) and abdominal compartment syndrome reports appear in literature. Pathophysiologic implications due to increased intraabdominal pressure (IAP) on organ function within the abdomen are transcendental critically ill neonate, pediatric and adult patients. This review focuses on the available literature on definitions, epidemiology, measurement, pathophysiologic implications, radiological findings and treatment. Key messages: (1) Body mass index and fluid resuscitation are independent predictors of IAH. (2) IAH increases intrathoracic, intracranial and intracardiac filling pressure and decreases left ventricular, chest wall and respiratory tract compliance. (3) IAH causes atelectasia and increases extravascular lung water. (4) PEEP can be set to counteract intraabdominal pressure. (5) Lung protective strategies should aim DPplat (plateau pressure-IAP). (6) Transdiaphragmatic filling pressures and volumetric parameters better reflect preload. (7) IAH is an independent predictor of acute renal failure. (8) IAH triggers bacterial translocation and multiple organ failure. (9) Monitoring of abdominal perfusion pressure can be useful.