Acute Crit Care.  2023 Nov;38(4):399-408. 10.4266/acc.2023.01263.

Abdominal compartment syndrome in critically ill patients

• Jang H
• Lee N
• Jeong E
• Park Y
• Jo Y
• Kim J
• Kim D

• KMID: 2550896
• DOI: http://doi.org/10.4266/acc.2023.01263

Abstract

Intra-abdominal hypertension can have severe consequences, including abdominal compartment syndrome, which can contribute to multi-organ failure. An increase in intra-abdominal hypertension is influenced by factors such as diminished abdominal wall compliance, increased intraluminal content, and certain systemic conditions. Regular measurement of intra-abdominal pressure is essential, and particular attention must be paid to patient positioning. Nonsurgical treatments, such as decompression of intraluminal content using a nasogastric tube, percutaneous drainage, and fluid balance optimization, play crucial roles. Additionally, point-of-care ultrasonography aids in the diagnosis and treatment of intra-abdominal hypertension. Emphasizing the importance of regular measurements, timely decompressive laparotomy is a definitive, but complex, treatment option. Balancing the urgency of surgical intervention against potential postoperative complications is challenging.

Keyword

abdominal compartment syndrome; critical care; intra-abdominal hypertension; multiple organ failure

Figure

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  Figure 1. Intra-abdominal hypertension (IAH) grade definition. The red section in the figure indicates the potential range for the onset of abdominal compartment syndrome (ACS). As illustrated, ACS can manifest in any situation of IAH; however, the probability increases as the grade escalates [12].

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  Figure 2. Intra-abdominal hypertension (IAH) or abdominal compartment syndrome (ACS) definition from the consensus definitions of the 2013 World Society of the Abdominal Compartment Syndrome [12].

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  Figure 3. Management of intra-abdominal hypertension/abdominal compartment syndrome. IAP: intra-abdominal pressure.

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