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Abdominal compartment syndrome powerpoint slides
- 2. Organ dysfuction caused by intraabdominal pressure. IAP is steady state Critical ill-5-7 normal Directly related to BMI Abdominal perfusion pressure MAP-IAP better than other predictive index At least 60mmHg SAMPLE FOOTER TEXT 20XX 2
- 3. INTRAABDOMINAL HYPERTENSION Increase abdominal pressure 12mmHg Grade1 12-15mmHg Grade2 16-20mmHg Grade3 21-25mmHg Grade4 above 25mmHg Dynamically Hyperacute seconds Acute hours rapid ACS Subacute days lead ACS Chronic mounths higher risk SAMPLE FOOTER TEXT 20XX 3
- 4. ABDOMINAL COMPARTMENT SYNDROME IAP increase 20mmHg APP decrease 60mmHg Plus new organ dysfunction. Elevate abdominal girth in protective mechanism in cirrhotic patients. SAMPLE FOOTER TEXT 20XX 4
- 5. RISKFACTOR-WIDELY Trauma-excessive fluid replacement Burned area 30% high Liver transplantation Abdominal condition massive ascites abdominal surgery intraabdominal pressure Retroperitoneal pancreatitis aorta aneurism Fluid third spacing crystalloid fluid replacement Classification Primary Secondary-rapid fluid replacement SAMPLE FOOTER TEXT 20XX 5
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- 7. Pulmonary Mvpatient increase peak inspiratory and mean airway pressure-alveolar barotrauma Reduce chest wall compliance-arterial hypoxia and hypercarbia-Pneaumonia Induce acid base balance Renal Renal vein compression-renal impairment Renal artery constriction-induce by the RAAS and symphatics.-Cardiac output fall Above 30mmHg-anuria 15 olygouria Decrease serum K and Na SAMPLE FOOTER TEXT 20XX 7
- 8. GI tract Mesenteric blood flow reduce AP low 10mmHg Mucosal perfusion decrease above 30mmHg CT and SMA perfusion impairment above 40mmHg Mesenteric vein compress-bowel edema- bowel ischemia-decrease mucosal pH-lactic acidosis Hemorrhage-10mmHg-gut mucosal barrier impairment-bacterial translocation-sepsis SBP Liver Lactic acid accumulation Acidosis Cerebral ischemia SAMPLE FOOTER TEXT 20XX 8
- 9. Symptoms Altered mental status Malaise Weakness Dyspnea Abdominal pain and bloating Examinations Distended abdomen Increase olygouria and increased ventilatory requirement Jugular vein distention Edema Acute pulmonary decompression SAMPLE FOOTER TEXT 20XX 9
- 10. Imaging findings Chest xray CT - infiltration retroperitoneum extrinsic compression of the IVC massive abdominal distention direct renal compression displacement bowel wall thickening Echo-confirm NG tube positioning evalutation gastric distention and bladder distention evalute bowel movement identify bowel content and free fluid Diagnosis Measurement bladder pressure SAMPLE FOOTER TEXT 20XX 10
- 11. MANAGEMENT Supportive care Improve abdominal wall compliance Pain management Avoid positive fluid balance Evacuation of intraluminal content and intraabdominal content Elevation head of bed 20 degree Surgical intervention Goal treatment Greater 25mmHg APP-below 50mmHg Only perform medically stable patients Failure to drain at least 1000ml of fluid and decrease IAP by at least 9mmHg in the first 4 hours following decompression is associated with failure and should prompt urgent surgical decompression SAMPLE FOOTER TEXT 20XX 11
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- 13. https://www.youtube.com/watch?v=hUU5Yy2i EPM SAMPLE FOOTER TEXT 20XX 13