Abdominal Compartment Syndrome: A Comprehensive Pathophysiological Review

Abstract

With growing knowledge and advances in surgery and critical care, we are witnessing new concepts and understanding in spectrum of disease pathology. Abdominal compartment syndrome (ACS) or intraabdominal hypertension (IAH) is one such intriguing entity that has rapidly caught attention of all surgeons and intensivists. Lately, lot of researches are showing the correlation of ACS-IAH with worse outcomes and even mortality in sick patients. IAH has been found to be an important contributor to early organ dysfunction among patients with trauma and sepsis that can cause significant impairment of renal, gastrointestinal, hepatic, cardiac, pulmonary, and central nervous system function. The pathology is even more significant in cases of abdominal surgery or trauma. ACS-IAH is commonly seen in severely sick patients, with prevalence reaching to as high as 50%. There is an increasing awareness of IAH as evidenced by increasing number of studies in the literature. Although there is lot of documented evidence around the topic of ACS-IAH, measuring and managing it still does not figure in most of protocols and practice guidelines in India. The authors believe that a thorough understanding about IAH will enable medical professional in reducing surgical mortality and morbidity. Hence, there was a need to review literature for the latest concept and evidence especially in the area of ACS-IAH, in context of our country India, where there is dearth of knowledge in this subject and its implications. The present review is set to present the current understanding of IAH from pathophysiological and clinical point of view with future insights.

Keywords

• Abdominal compartment syndrome (ACS)
• intraabdominal hypertension (IAH)
• intraabdominal pressure (IAP)
• mortality
• organ dysfunction