The role of abdominal compliance, the neglected parameter in critically ill patients — a consensus review of 16. Part 2: measurement techniques and management recommendations

Abstract

The recent definitions on intra-abdominal pressure (IAP), intra-abdominal volume (IAV) and abdominal compliance (C ab ) are a step forward in understanding these important concepts. They help our understanding of the pathophysiology, aetiology, prognosis, and treatment of patients with low C ab . However, there is still a relatively poor understanding of the different methods used to measure IAP, IAV and C ab and how certain conditions may affect the results. This review will give a concise overview of the different methods to

Abdominal pressure and gastrointestinal function: an inseparable couple?

“…Signs of organ dysfunction, duration of mechanical ventilation, ICU length of stay and ICU mortality are increased in most studies [10,11,25]. whether a patient develops IAH or abdominal compartment syndrome (ACS) [9,[26][27][28][29].…”

“…The effect of increasing intra-abdominal volume on the development of IAH. [26][27][28][29]. Abdominal compliance -a measure of the ease of abdominal expansion -differs between individuals (e.g.…”

The Neglected Role of Abdominal Compliance in Organ-Organ Interactions

“…The C abRAVT in the sample shown can be calculated as follows: C abRAVT = ΔV T /ΔIAP ei = 750/ (13.6 − 11.5) = 357.1 ml/mmHg and this correlates well with the C abVT :C abVT = V T /ΔIAP = 1000/(13.6 − 11) = 384.6 ml/mmHg. Adapted from [3] with permission mechanical ventilation; increasing tidal volume increases IAP ei while increasing PEEP increases IAP ee .…”

“…Patients with android obesity do not have this reshaping and stretching capability. Adapted from [2] with permission dialysis or by drainage of intra-abdominal fluid (ascites in liver cirrhosis, peripancreatic fluid or pseudocyst, serous fluid collections in trauma or burns) [2][3][4].…”

“…C ab should be expressed as the change in IAV per change in IAP (expressed in ml/mmHg). C ab is one of the most neglected parameters in critically ill patients, despite playing a key-role in understanding the deleterious effects of unadapted IAV on IAP, organ-organ interactions and end-organ perfusion [2,3]. Although there are some papers related to C ab in surgical patients, only a few papers have been published addressing this issue in critically ill patients [2][3][4].…”