Damage Control in Abdominal Compartment Syndrome

  • Cheng Zhao
  • Jianan Ren


Abdominal compartment syndrome (ACS) is the endpoint of increased intra-abdominal pressure (IAP) which is the result of massive interstitial swelling in the abdomen or rapid development of a space-filling lesion within the abdomen. The intra-abdominal hypertension (IAH) leads to decreased abdomen perfusion pressure (APP) resulting in abdominal viscera dysfunction contributing to multi-organ dysfunction (MOD) and ischemia which lead to high mortality. Measurement has been taken to monitor the IAP for the contradiction between resuscitation and the massive interstitial swelling which lead to IAH. Besides the monitor measurements, damage control was introduced to save the severely injured patients who are on the edge of physiological limit. Damage control resuscitation and damage control surgery were conducted to maintain the balance among physiological limit, resuscitation, and controllable IAP. There is minimal original article about the pathophysiology of ACS. Most results were from clinical trial. Many early studies of IAH and ACS used discordant definitions or cutoff pressure values. In this review, nomenclature will follow the terminology established by the World Society of the Abdominal Compartment Syndrome (WSACS) which has recently been standardized and accepted widely. This chapter reviewed the history and the pathophysiology of ACS and the application of damage control.


Abdominal compartment syndrome Damage control surgery Intra-abdominal hypertension Multi-organ dysfunction Open abdomen 



Abdominal compartment syndrome


Abdominal perfusion pressure


Advanced trauma life support


Intra-abdominal hypertension


Intra-abdominal pressure


Intensive care unit


Mean arterial pressure


Massive transfusion protocol


Open abdomen


Percutaneous catheter drainage


Positive end-expiratory pressure


Pulse pressure variation


Temporary abdominal closure


Tissue plasminogen activator


World Society of the Abdominal Compartment Syndrome


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Cheng Zhao
    • 1
  • Jianan Ren
    • 1
  1. 1.Department of SurgeryJinling Hospital, Medical School of Nanjing UniversityNanjingChina

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