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World J Surg. 2009 Jun;33(6):1123-7. doi: 10.1007/s00268-009-0040-4.

Intra-abdominal pressure and abdominal compartment syndrome in acute general surgery.

Author information

1
Department of Surgery, Letterkenny General Hospital and Galway University Hospitals, Letterkenny, Donegal, Ireland. acstrauma@hotmail.com

Abstract

BACKGROUND:

Intra-abdominal pressure (IAP) is a harbinger of intra-abdominal mischief, and its measurement is cheap, simple to perform, and reproducible. Intra-abdominal hypertension (IAH), especially grades 3 and 4 (IAP > 18 mmHg), occurs in over a third of patients and is associated with an increase in intra-abdominal sepsis, bleeding, renal failure, and death.

PATIENTS AND METHODS:

Increased IAP reading may provide an objective bedside stimulus for surgeons to expedite diagnostic and therapeutic work-up of critically ill patients. One of the greatest challenges surgeons and intensivists face worldwide is lack of recognition of the known association between IAH, ACS, and intra-abdominal sepsis. This lack of awareness of IAH and its progression to ACS may delay timely intervention and contribute to excessive patient resuscitation.

CONCLUSIONS:

All patients entering the intensive care unit (ICU) after emergency general surgery or massive fluid resuscitation should have an IAP measurement performed every 6 h. Each ICU should have guidelines relating to techniques of IAP measurement and an algorithm for management of IAH.

PMID:
19404708
DOI:
10.1007/s00268-009-0040-4
[Indexed for MEDLINE]

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