The abdominal compartment syndrome: a complication with many faces

Citation
P. Berger et al., The abdominal compartment syndrome: a complication with many faces, NETH J MED, 58(5), 2001, pp. 197-203
Citations number
29
Language
INGLESE
art.tipo
Article
Categorie Soggetti
General & Internal Medicine
Journal title
NETHERLANDS JOURNAL OF MEDICINE
ISSN journal
0300-2977 → ACNP
Volume
58
Issue
5
Year of publication
2001
Pages
197 - 203
Database
ISI
SICI code
0300-2977(200105)58:5<197:TACSAC>2.0.ZU;2-P
Abstract
Background: Lately renewed attention has been given to the abdominal compar tment syndrome. Despite of this there still remain a lot of controversies w ith regard to the pathophysiological mechanisms underlying this syndrome an d the therapeutic options. Methods: Two cases of patients with this syndrom e are described and the data from animal and human trials concerning the ab dominal compartment syndrome are presented and discussed. Results: A variet y of clinical disorders may lead to the abdominal compartment syndrome. It mainly affects the cardiovascular, pulmonary and renal organ systems. Altho ugh some clinical effects are clearly described, the exact mechanisms under lying these changes in humans are incompletely understood. It is still uncl ear why some patients develop abdominal compartment syndrome and others do not. The intra-abdominal pressure can easily be assessed by measuring the u rine bladder pressure, which correlates well with the actual intra-abdomina l pressure. All authors agree that a decompression of the abdomen by means of a laparotomy is the treatment of choice for the abdominal compartment sy ndrome. Which parameters should determine the indication however, remains c ontroversial, since the correlation between clinical signs and pressure is not straightforward. Conclusions: The abdominal compartment syndrome is a w ell-recognised disease entity related to acutely increased abdominal pressu re. Urgent laparotomy can be lifesaving in some cases. However no single th reshold of abdominal pressure can be applied universally. Pending further c linical trials the best therapeutic option seems to be to decompress the ab domen surgically if the intravesical pressure is 25 mmHg or higher in patie nts with refractory hypotension, acute renal failure or respiratory failure due to abdominal distension. (C) 2001 Elsevier Science B.V. All rights res erved.