Understanding Intra-Abdominal Hypertension

Abstract

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are highly morbid conditions that are common and underrecognized in the intensive care unit. Intra-abdominal hypertension affects the critically ill patient population and is not solely limited to the trauma and surgical subgroups. The recognition of IAH and ACS as distinct clinical states has become more apparent. Extensive bench and clinical research has shed significant light into the definition, incidence, etiology, physiology, clinical manifestations, and treatment strategies. Although further research into this morbid condition is needed, improvement in recognition is a critical first step. This review aims to scrutinize the basic science and clinical literature available on this condition in a surgically focused, organ-system-based approach.

Effects of intraabdominal pressure on mean platelet volume during laparoscopic cholecystectomy

“…ACS is a life-threatening but treatable disease that requires early diagnosis and proper management. Unfortunately, physical examination has not been shown to be effective in the diagnosis of IAH and ACS (11).…”

Modulação da pressão intracraniana em um modelo experimental de hipertensão abdominal e lesão pulmonar aguda

“…(13) Recently, several works have highlighted the impact of intra-abdominal pressure on critical disease pathophysiology, especially its correlation with renal disease. (14) The association between ALI and IAH is a clinical challenge, as higher airway pressures may be required to expand the lungs because of abdominal cavity restriction. (15) Concomitantly, a higher intra-thoracic pressure may worsen IAH, perpetuating a progressive cycle that may worsen the patient's conditions.…”

Kidney Injury in Abdominal Compartment Syndrome

“…Reprinted from Al-Mufarrej et al [ 15 ] Abbreviations: IAH intra-abdominal hypertension, IAP intra-abdominal pressure The incidence of IAH and ACS varies with the patient population studied with ranges as high as 40.7 % of admissions to a surgical intensive care unit [ 8 ] and between 4 and 8 % among general medical-surgical patients [ 9 ]. The incidence of associated multiorgan failure (MOF) and mortality is also high.…”

“…This priming effect predisposes a patient to a subsequent exaggerated neutrophil response and has been linked to organ dysfunction [ 15 ]. Shah et al reviewed substantial evidence suggesting the systemic reabsorption of mesenteric-derived lymphatic fl uid leads to neutrophil priming and is associated with distant organ failure.…”