Anatomy and Physiology of the Abdominal Compartment
Increasing attention has been paid to understanding the etiology, pathophysiology, prognosis, and treatment of increased intra-abdominal pressure (IAP) in surgical, trauma, and medical patients. Intra-abdominal hypertension (IAH) is a graded phenomenon; however, abdominal compartment syndrome (ACS) is an all-or-none condition resulting in dysfunction of neurological, respiratory, cardiovascular, renal, and hepatic organ systems. This chapter provides a detailed overview of the historical background, definitions, classification, epidemiology, and pathophysiology related to IAH and ACS, including different IAP measurement techniques.
Dr. MLNG Malbrain is the founding president of WSACS and current treasurer; he is a member of the medical advisory board of Pulsion Medical Systems (Maquet Getinge group), a monitoring company, and consults for KCI, ConvaTec, and Holtech Medical. He is also a member of the Executive Committee of the International Fluid Academy, an online educational platform adhering to the FOAM principles (Free Open Access Medical Education, www.fluidacademy.org), and part of the not-for-profit organization iMERiT (International Medical Education and Research Initiative). The other authors have no potential conflicts of interest.
- 3.Kirkpatrick AW, Roberts DJ, De Waele J, Jaeschke R, Malbrain ML, De Keulenaer B, et al. Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med. 2013;39(7):1190–206.CrossRefPubMedPubMedCentralGoogle Scholar
- 6.Malbrain ML, Chiumello D, Cesana BM, Reintam Blaser A, Starkopf J, Sugrue M, et al. A systematic review and individual patient data meta-analysis on intra-abdominal hypertension in critically ill patients: the wake-up project. World initiative on abdominal hypertension epidemiology, a unifying project (WAKE-Up!). Minerva Anestesiol. 2014;80(3):293–306.PubMedGoogle Scholar
- 8.Van Hee R. Historical highlights in concept and treatment of abdominal compartment syndrome. Acta Clin Belg Suppl. 2007;62(1):9–15.Google Scholar
- 10.Kirkpatrick AW, De Waele JJ, De Laet I, De Keulenaer BL, D’Amours S, Bjorck M, et al. WSACS--The Abdominal Compartment Society. A Society dedicated to the study of the physiology and pathophysiology of the abdominal compartment and its interactions with all organ systems. Anaesthesiol Intensive Ther. 2015;47(3):191–4.CrossRefPubMedGoogle Scholar
- 11.Malbrain MLNG, De laet I, De Waele J, Sugrue M, Schachtrupp A, Duchesne J, et al. The role of abdominal compliance, the neglected parameter in critically ill patients - a consensus review of 16. Part 2: measurement techniques and management recommendations. Anaesthesiol Intensive Ther. 2014;46(5):406–32.CrossRefPubMedGoogle Scholar
- 12.Malbrain MLNG, Roberts DJ, De laet I, De Waele J, Sugrue M, Schachtrupp A, et al. The role of abdominal compliance, the neglected parameter in critically ill patients - a consensus review of 16. Part 1: definitions and pathophysiology. Anaesthesiol Intensive Ther. 2014;46(5):392–405.CrossRefPubMedGoogle Scholar
- 21.Mulier J, Dillemans B, Crombach M, Missant C, Sels A. On the abdominal pressure volume relationship. Int J Anesthesiol. 2008;21(1):5221–31.Google Scholar
- 22.Holodinsky JK, Roberts DJ, Ball CG, Blaser AR, Starkopf J, Zygun DA, et al. Risk factors for intra-abdominal hypertension and abdominal compartment syndrome among adult intensive care unit patients: a systematic review and meta-analysis. Crit Care. 2013;17(5):R249.CrossRefPubMedPubMedCentralGoogle Scholar
- 29.Peeters Y, Lebeer M, Wise R, Malbrain ML. An overview on fluid resuscitation and resuscitation endpoints in burns: past, present and future. Part 2 - avoiding complications by using the right endpoints with a new personalized protocolized approach. Anaesthesiol Intensive Ther. 2015;47(J):15–26.CrossRefGoogle Scholar