Abdominal Compartment Syndrome as a Multidisciplinary Challenge. A Literature Review

J Crit Care Med (Targu Mures). 2018 Oct 1;4(4):114-119. doi: 10.2478/jccm-2018-0024. eCollection 2018 Oct.

Abstract

Abdominal Compartment Syndrome (ACS), despite recent advances in medical and surgical care, is a significant cause of mortality. The purpose of this review is to present the main diagnostic and therapeutic aspects from the anesthetical and surgical points of view. Intra-abdominal hypertension may be diagnosed by measuring intra-abdominal pressure and indirectly by imaging and radiological means. Early detection of ACS is a key element in the ACS therapy. Without treatment, more than 90% of cases lead to death and according with the last reports, despite all treatment measures, the mortality rate is reported as being between 25 and 75%. There are conflicting reports as to the importance of a conservative therapy approach, although such an approach is the central to treatment guidelines of the World Society of Abdominal Compartment Syndrome, Decompressive laparotomy, although a backup solution in ACS therapy, reduces mortality by 16-37%. The open abdomen management has several variants, but negative pressure wound therapy represents the gold standard of surgical treatment.

Keywords: abdominal compartment syndrome; decompressive laparotomy; intra-abdominal pressure.

Publication types

  • Review