Slovenská chirurgia 3/2022

Abdominal compartment syndrome: current recommendations and literature review

Intra-abdominal hypertension (IAH ) and abdominal compartment syndrome (ACS) represent serious medical diagnoses, and the prevalence and morbidity of these diseases are relatively high in critically ill patients. The mortality rate of ACS ranges from 60-70%. Therefore, it is essential that all doctors providing intensive care, especially for surgical patients, are informed about the pathophysiological nature of the disease, diagnosis, treatment options and are able to recognize the presence of risk factors. Risk factors are: reduced abdominal wall compliance, increased intraluminal content, abdominal cavity collections and fluid resuscitation with „capillary leak“. If the presence of risk factors is verified, regular, possibly continuous monitoring of intra-abdominal pressure (IAP) is indicated. This is realized through an indirect measurement of the pressure in the bladder. Conservative management must be initiated immediately and includes evacuation of intraluminal contents, evacuation of abdominal collections, improve abdominal wall compliance, optimization of fluid balance and optimization of systemic and regional perfusion. If IAH continues to increase or ACS develops, decompressive laparotomy is indicated using a temporary closure of the abdominal wall using abdominal vacuum therapy. Our article presents an up-to-date review of the issue of IAH and ACS, including the latest recommendations formed by a group of specialists from WSACS (Abdominal Compartment Society).

Keywords: intra-abdominal pressure, intra-abdominal hypertension, abdominal compartment syndrome, decompresive laparotomy