&lt;p&gt;Abdominal Compartment Syndrome: Improving Outcomes With A Multidisciplinary Approach – A Narrative Review&lt;/p&gt;

Padar, Martin; Blaser, Annika Reintam; Talving, Peep; Lipping, Edgar; Starkopf, Joel

doi:10.2147/jmdh.s205608

Cited by 37 publications

(40 citation statements)

References 96 publications

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“…Recently, data on prevalence of IAH and ACS were summarized by Padar et al [5]. Data of 285 consecutive patients from a mixed medical-surgical intensive care unit (ICU) showed that ACS occurred in 3% of patients [3].…”

Section: Introductionmentioning

confidence: 99%

“…Intra-abdominal hypertension (IAH) is frequently present in critically ill patients and is an independent predictor for mortality [ 1 – 3 ]. When IAH progresses to abdominal compartment syndrome (ACS), organ failure occurs by definition [ 4 ] and mortality is very high [ 5 ]. World Society of the Abdominal Compartment Syndrome (WSACS, currently WSACS—the Abdominal Compartment Society) guidelines recommend protocolized monitoring of intra-abdominal pressure (IAP) in high-risk patients every 4–6 h [ 4 , 6 ] .…”

Section: Introductionmentioning

confidence: 99%

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Intra-abdominal hypertension and abdominal compartment syndrome in patients admitted to the ICU

Smit

Koopman

Dieperink

et al. 2020

Ann. Intensive Care

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Background Intra-abdominal hypertension is frequently present in critically ill patients and is an independent predictor for mortality. Risk factors for intra-abdominal hypertension and abdominal compartment syndrome have been widely investigated. However, data are lacking on prevalence and outcome in high-risk patients. Our objectives in this study were to investigate prevalence and outcome of intra-abdominal hypertension and abdominal compartment syndrome in high-risk patients in a prospective, observational, single-center cohort study. Results Between March 2014 and March 2016, we included 503 patients, 307 males (61%) and 196 females (39%). Patients admitted to the intensive care unit with a diagnosis of pancreatitis, elective or emergency open abdominal aorta surgery, orthotopic liver transplantation, other elective or emergency major abdominal surgery and trauma were enrolled. One hundred and sixty four (33%) patients developed intra-abdominal hypertension and 18 (3.6%) patients developed abdominal compartment syndrome. Highest prevalence of abdominal compartment syndrome occurred in pancreatitis (57%) followed by orthotopic liver transplantation (7%) and abdominal aorta surgery (5%). Length of intensive care stay increased by a factor 4 in patients with intra-abdominal hypertension and a factor 9 in abdominal compartment syndrome, compared to patients with normal intra-abdominal pressure. Rate of renal replacement therapy was higher in abdominal compartment syndrome (38.9%) and intra-abdominal hypertension (8.2%) compared to patients with normal intra-abdominal pressure (1.2%). Both intensive care mortality and 90-day mortality were significantly higher in intra-abdominal hypertension (4.8% and 15.2%) and abdominal compartment syndrome (16.7% and 38.9%) compared to normal intra-abdominal pressure (1.2% and 7.1%). Body mass index (odds ratio 1.08, 95% confidence interval 1.03–1.13), mechanical ventilation at admission (OR 3.52, 95% CI 2.08–5.96) and Apache IV score (OR 1.03, 95% CI 1.02–1.04) were independent risk factors for the development of intra-abdominal hypertension or abdominal compartment syndrome. Conclusions The prevalence of abdominal compartment syndrome was 3.6% and the prevalence of intra-abdominal hypertension was 33% in this cohort of high-risk patients. Morbidity and mortality increased when intra-abdominal hypertension or abdominal compartment syndrome was present. The patient most at risk of IAH or ACS in this high-risk cohort has a BMI > 30 kg/m2 and was admitted to the ICU after emergency abdominal surgery or with a diagnosis of pancreatitis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intra-abdominal hypertension and abdominal compartment syndrome in patients admitted to the ICU

Smit

Koopman

Dieperink

et al. 2020

Ann. Intensive Care

View full text Add to dashboard Cite

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“…Mortality is associated with the grade of IAH (Grade I: 10%-25%, Grade-II: 15%-45%, Grade III-IV: 50%-60%), and studies have found IAH to be an independent predictor of mortality[ 17 , 19 ]. ACS carries a mortality risk reported by 75%-90%[ 19 ].…”

Section: Epidemiology/mortalitymentioning

confidence: 99%

“…Continuous hemodynamic monitoring will guide goal-directed fluid resuscitation and the use of damaged control resuscitation as needed[ 2 ]. However, clinicians should keep in mind that parameters like central venous pressure, pulmonary capillary wedge pressure, ultrasound compression of inferior vena cava, mean arterial pressure, among others, may not be reliable during ACS[ 19 ].…”

Section: Managementmentioning

confidence: 99%

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Abdominal compartment syndrome among surgical patients

León¹,

Chavez²,

Surani³

2021

WJGS

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Abdominal compartment syndrome (ACS) develops when organ failure arises secondary to an increase in intraabdominal pressure. The abdominal pressure is determined by multiple factors such as blood pressure, abdominal compliance, and other factors that exert a constant pressure within the abdominal cavity. Several conditions in the critically ill may increase abdominal pressure compromising organ perfusion that may lead to renal and respiratory dysfunction. Among surgical and trauma patients, aggressive fluid resuscitation is the most commonly reported risk factor to develop ACS. Other conditions that have also been identified as risk factors are ascites, hemoperitoneum, bowel distention, and large tumors. All patients with abdominal trauma possess a higher risk of developing intra-abdominal hypertension (IAH). Certain surgical interventions are reported to have a higher risk to develop IAH such as damage control surgery, abdominal aortic aneurysm repair, and liver transplantation among others. Close monitoring of organ function and intra-abdominal pressure (IAP) allows clinicians to diagnose ACS rapidly and intervene with target-specific management to reduce IAP. Surgical decompression followed by temporary abdominal closure should be considered in all patients with signs of organ dysfunction. There is still a great need for more studies to determine the adequate timing for interventions to improve patient outcomes.

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