Intraabdominal Hypertension and Abdominal Compartment Syndrome in Trauma: Pathophysiology and Interventions

Abstract

The triad of hypothermia, acidosis, and coagulopathy during initial operative and resuscitation efforts has been recognized as a significant cause of death in patients with traumatic injuries. A staged surgical approach with a brief initial laparotomy, subsequent intensive care unit resuscitation, and a planned reoperation is an emerging technique used in trauma surgery, with application to a variety of other surgical challenges. Successful damage control therapy requires a coordinated multidisciplinary team effort by a trauma team experienced in the process of damage control operations, intensive care unit priorities, and potential complications of this innovative surgical approach.

Sonographic assessment of abdominal vein dimensional and hemodynamic changes induced in human volunteers by a model of abdominal hypertension*

“…The peritoneal cavity is a confined anatomical space; hence, intra-abdominal hypertension (IAH) can impair organ functions (2,3) and lead to the development of abdominal compartment syndrome, with potentially devastating consequences (4). Any abnormality that elevates the pressure within the peritoneal cavity can induce abdominal compartment syndrome.…”

A Retrospective Exploration of Patient‐Ventilator Monitoring Intensity, Therapeutic Intervention Intensity, and Compliance with Lung Protective Guidelines in a Cohort of Patients with Adult Respiratory Distress Syndrome

“…Risk for elevated abdominal pressure was measured as present or absent by the principal investigator based on review of the medical record. Subjects with documented risk factors such as abdominal wounds, acsites, and/or bowel obstructions were considered at risk for elevated abdominal pressure (Lozen 1999; Malbrain 2000; Reed et al 2006).…”

A prospective study of outcome in patients with intra-abdominal hypertension

“…6 The abdominal compartment syndrome has been defined as an intra-abdominal pressure of > 25 mm Hg, complicated by one of the following: Peak air way pressure >40 cm H2O, oxygen delivery index <600 ml O2/min/m 2 , or urine output <0.5 ml/kg/hr. 6,7 Intravehicular pressure has been found to have good correlation with the intra-abdominal pressure (IAP). 8,9 The gastric pressure measurement has also been studied especially in patients with acute renal failure.…”