Abdominal compartment syndrome

1. Abdominal compartment syndrome
Etiology
• ↑ intraabdominal pressure causing organ dysfunction
• Risk factors:
• Massive fluid resuscitation (eg, trauma, sepsis)
• Major intraabdominal surgery or pathology (eg, pancreatitis)
• Intraabdominal fluid collections (eg, bleeding, ascites)
Clinical
manifestations
• Tense, distended abdomen
• ↑ ventilatory requirements (diaphragmatic elevation, ↑
intrathoracic pressure)
• ↑ CVP (venous compression but ↓ venous return & cardiac preload)
• Hypotension, tachycardia (↓ venous return & cardiac output)
• ↓ urine output (↓ intraabdominal organ perfusion)
Management
• Temporizing measures:
• Avoid over-resuscitation with fluids
• ↓ intraabdominal volume (eg, NG tube, drain fluid
collections)
• ↑ abdominal wall compliance (eg, sedation, paralysis)
• Definitive management: surgical decompression