Resumo
Definition
History and exam
Key diagnostic factors
- abdominal distension
- oliguria
- increased respiratory effort
- hypotension
Risk factors
- excessive fluid resuscitation (>3 L in 24 hours)
- massive blood transfusion (>10 units in 24 hours)
- decreased abdominal compliance
- intra-abdominal infection/inflammation
- hemoperitoneum
- ileus
- pneumoperitoneum
- loss of abdominal domain
- comorbid cirrhosis
- retroperitoneal hematoma
Diagnostic investigations
1st investigations to order
- transbladder measurement of intra-abdominal pressure
- oxygen saturation
- BUN and creatinine
- arterial blood gases
Investigations to consider
- peak airway pressure
- abdominal CT scan
- abdominal ultrasound
Emerging tests
- measurement of intra-abdominal pressure via vena cava, rectum, or abdominal cavity
Treatment algorithm
all patients
Contributors
Authors
Michael W. Cripps, MD
Assistant Professor
Department of Surgery
Division of Burn/Trauma/Critical Care
University of Texas Southwestern Medical Center
Dallas
TX
Disclosures
MWC has been reimbursed by Hemosonics and Instrumentation Laboratory for consultancy.
Jeffrey C. Perumean, MD
Surgeon/Surgical Intensivist
Advanced Surgical Associates/Banner Health
Division of Trauma/Critical Care
Mesa
AZ
Divulgaciones
JCP declares that he has no competing interests.
Agradecimientos
Dr Michael Cripps and Dr Jeffrey Perumean would like to gratefully acknowledge Dr Michaela West and Dr Gary An, previous contributors to this topic. MW and GA are authors of a reference cited in this topic.
Revisores por pares
Bart De Keulenaer, MD, FJFICM
Physician/Intensivist
Fremantle Hospital
Fremantle
Western Australia
Australia
Divulgaciones
BDK declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
The World Society of the Abdominal Compartment Syndrome. WSACS consensus guidelines summary. Apr 2021 [internet publication].Texto completo
An G, West MA. Abdominal compartment syndrome: a concise clinical review. Crit Care Med. 2008 Apr;36(4):1304-10. Resumen
Iberti TJ, Kelly KM, Gentili DR, et al. A simple technique to accurately determine intra-abdominal pressure. Crit Care Med. 1987Dec;15(12):1140-2. Resumen
Cheatham ML, Malbrain ML, Kirkpatrick A, et al. Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. II. Recommendations. Intensive Care Med. 2007 Jun;33(6):951-62. Resumen
de Laet IE, Malbrain M. Current insights in intra-abdominal hypertension and abdominal compartment syndrome. Med Intensiva. 2007 Mar;31(2):88-99. Resumen
Malbrain ML, De Laet I, Cheatham M. Consensus conference definitions and recommendations on intra-abdominal hypertension (IAH) and the abdominal compartment syndrome (ACS): the long road to the final publications, how did we get there? Acta Clin Belg Suppl. 2007;62(Suppl 1):44-59. Resumen
Artículos de referencia
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