UMEM Educational Pearls

Category: Critical Care

Title: Abdominal Compartment Syndrome

Keywords: abdominal compartment syndrome, decompressive laparotomy, bladder pressure (PubMed Search)

Posted: 10/8/2007 by Mike Winters, MD (Emailed: 10/9/2007) (Updated: 12/7/2019)
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[RESENT - STILL FIXING CODE - THESE TEST EMAILS SHOULD CEASE SHORTLY... SORRY FOR THE INCONVENIENCE]

  • Abdominal compartment syndrome (ACS) is increasingly identified in the critically ill medical patient population
  • ACS is defined as a sustained intra-abdominal pressure > 20 mmHg associated with new organ dysfunction
  • Primary organs adversely affected by ACS include cardiac, pulmonary, GI, and renal
  • To date, associated mortality rates have ranged from 27% to 50%
  • Risk factors for ACS include:
    • massive fluid resuscitation ( >10 L crystalloid in 24 hours)
    • massive transfusion ( > 10 U PRBCs in 24 hours)
    • severe sepsis or septic shock from any cause
    • mechanical ventilation
    • PEEP > 10 cm H20
  • Intravesicular (bladder) pressures are currently the standard monitoring modality
  • Decompressive laparotomy is the current standard for management of ACS