Skip to main content

Abdominal Compartment Syndrome

  • Chapter
Multiple Organ Failure

Abstract

Intraabdominal pressure (IAP) is one of the physical constants that can be modified with great ease at an early time in the presence of severe cavity alterations. An increase in IAP produces a hypertensive state (intraabdominal hypertension, or IAH) that is both the result and an indicator of underlying pathophysiolofgic alterations. IAH has marked effects, both local and systemic, that are liable to lead to multiorgan dysfunction and the full picture of the abdominal compartment syndrome (ACS).1

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ivatury RR, Diebel L, Porter JM, Simon RJ: Intra-abdominal hypertension and the abdominal compartment syndrome. Surg Clin North Am 1997; 77: 783–812.

    Article  PubMed  CAS  Google Scholar 

  2. Bloomfield GL, Ridings PC, Blocker CR, Marmarou A, Sugerman HJ: A proposed relationship between increased intra-abdominal, intrathoracic, and intracranial pressure. Crit Care Med 1997; 25: 496–503.

    Article  PubMed  CAS  Google Scholar 

  3. Cullen DJ, Coyle JP, Teplick R, Long MC: Cardiovascular, pulmonary, and renal effects of massively increased intra-abdominal pressure in critically ill patients. Crit Care Med 1989; 17: 118–121.

    Article  PubMed  CAS  Google Scholar 

  4. Ridings PC, Bloomfield GL, Blocher CR, Sugerman HJ: Cardiopulmonary effects of raised intra-abdominal pressure before and after intravascular volume expansion. J Trauma 1995; 39: 1071–1075.

    Article  PubMed  CAS  Google Scholar 

  5. Bumaschny E: The abdominal compartment syndrome. Curr Opin Crit Care 1998; 4: 236–244.

    Article  Google Scholar 

  6. Sugrue M, Jones F, Lee A, et al: Intraabdominal pressure and gastric intramucosal pH: is there an association? World J Surg 1996; 20: 988–991.

    Article  PubMed  CAS  Google Scholar 

  7. Morris JA Jr., Eddy VA, Blinman TA, Rutherford EJ, Sharp KW: Staged celiotomy for trauma: issues in unpacking and reconstruction. Ann Surg 1993; 217: 576–586.

    Article  PubMed  Google Scholar 

  8. Saggi BH, Sugerman HJ, Ivatury RR, Bloomfield GL: Abdominal compartment syndrome. J Trauma 1998; 45: 597–609.

    Article  PubMed  CAS  Google Scholar 

  9. Sugrue M, Hillman KM: Intra-abdominal hypertension and intensive care. In: Vincent JL (ed) Yearbook of Intensive Care and Emergency Medicine. Berlin, Springer 1998; 667–676.

    Google Scholar 

  10. Eddy V, Nunn C, Morris JA: Abdominal compartment syndrome: the Nashville experience. Surg Clin North Am 1997; 77: 801–812.

    Article  PubMed  CAS  Google Scholar 

  11. Meldrum DR, Moore FA, Moore EE, Franciose RJ, Sauaia A, Burch JM: Prospective characterization and selective management of the abdominal compartment syndrome. Am J Surg 1997; 174: 667–673.

    Article  PubMed  CAS  Google Scholar 

  12. Diebel LN, Dulchavsky SA, Wilson RF: Effect of increased intraabdominal pressure on mesenteric arterial and intestinal mucosal blood flow. J Trauma 1992; 33: 45–49.

    Article  PubMed  CAS  Google Scholar 

  13. Burch JM, Moore EE, Moore FA, Franciose R: The abdominal compartment syndrome. Surg Clin North Am 1996; 76: 833–1142.

    Article  PubMed  CAS  Google Scholar 

  14. Harman PK, Kron IL, McLachlan HD, Freedlender AE, Nolan SP: Elevated intra-abdominal pressure and renal function. Ann Surg 1982; 196: 594–947.

    Article  PubMed  CAS  Google Scholar 

  15. Overholt RH: Intraperitoneal pressure. Arch Surg 1931; 22: 691–703.

    Article  Google Scholar 

  16. Bradley SE, Bradley GP: The effect of increased infra-abdominal pressure on renal function in man. J Clin Invest 1947; 26: 1010–1022.

    Article  PubMed  CAS  Google Scholar 

  17. Gross R: A new method for surgical treatment of large omphaloceles. Surgery 1948; 24: 277–292.

    PubMed  CAS  Google Scholar 

  18. Richardson JD, Trinkle JK: Hemodynamic and respiratory alterations with increased intra-abdominal pressure. J Surg Res 1976; 20: 401–404.

    Article  PubMed  CAS  Google Scholar 

  19. Richards WO, Scovill W, Shin B, Reed W: Acute renal failure associated with increased intra-abdominal pressure. Ann Surg 1983; 197: 183–187.

    Article  PubMed  CAS  Google Scholar 

  20. Kron IL, Harman PK, Nolan SP: Measurement of intra-abdominal pressure as a criterion for abdominal re-exploration. Ann Surg 1984; 199: 28–30.

    Article  PubMed  CAS  Google Scholar 

  21. Fietsam R Jr., Villalba M, Glover JL, Clark K: Intra-abdominal compartment syndrome as a complication of ruptured abdominal aortic aneurysm repair. Am Surg 1989; 55: 396–402.

    PubMed  Google Scholar 

  22. Shenasky JH, Gillenwater JY: The renal hemodynamic and functional effects of external counterpressure. Surg Gynecol Obstet 1972; 134: 253–258.

    PubMed  Google Scholar 

  23. Diebel LN, Wilson RF, Dulchavsky SA, Saxe J: Effect of increased intra-abdominal pressure on hepatic arterial, portal venous, and hepatic microcirculatory blood flow. J Trauma 1992; 33: 279–283.

    Article  PubMed  CAS  Google Scholar 

  24. Schein M, Wittmann DH, Aprahamian CC, Condon RE: The abdominal compartment syndrome: the physiological and clinical consequences of elevated intra-abdominal pressure. J Am Coll Surg 1995; 180: 745–753.

    PubMed  CAS  Google Scholar 

  25. Bloomfield GL, Blocher CR, Fakhry BS, Sica DA, Sugerman HJ: Elevated intra-abdominal pressure increases plasma renin activity and aldosterone levels. J Trauma 1997; 42: 997–1005.

    Article  PubMed  CAS  Google Scholar 

  26. Pusajó JF, Bumaschny E, Egurrola MA, et al: Intra-abdominal pressure: its relation to splanchnic perfusion, sepsis, multiple organ failure and surgical reintervention. Intensive Crit Care Dig 1994; 13: 2–4.

    Google Scholar 

  27. Kashtan J, Green JF, Parsons EQ, Holcroft JW: Hemodynamic effects of increased abdominal pressure. J Surg Res 1981; 30: 249–225.

    Article  PubMed  CAS  Google Scholar 

  28. Hirshberg A, Mattox KL: Planned reoperation for severe trauma. Ann Surg 1995; 222: 3–8.

    Article  PubMed  CAS  Google Scholar 

  29. Paul A, Troidl H, Peters S, Stuttmann R: Fatal intestinal ischaemia following laparoscopic cholecystectomy. Br J Surg 1994; 81: 1207.

    Article  PubMed  CAS  Google Scholar 

  30. Obeid F, Saba A, Fath J, et al: Increases in intra-abdominal pressure affect pulmonary compliance. Arch Surg 1995; 130: 544–548.

    Article  PubMed  CAS  Google Scholar 

  31. Eleftheriadis E, Kotzampassi K, Papanotas K, Heliadis N, Sarris K: Gut ischemia, oxidative stress, and bacterial translocation in elevated abdominal pressure in rats. World J Surg 1996; 20: 11–16.

    Article  PubMed  CAS  Google Scholar 

  32. Oelschlager BK, Boyle EM Jr., Johansen K, Meissner MH: Delayed abdominal closure in the management of ruptured abdominal aortic aneurysms. Am J Surg 1997; 173: 411–415.

    Article  PubMed  CAS  Google Scholar 

  33. Bureh JM, Ortiz VB, Richardson RJ, Martin RR, Mattox KL, Jordan GL Jr.: Abbreviated laparotomy and planned reoperation for critically injured patients. Ann Surg 1992; 215: 476–484.

    Article  Google Scholar 

  34. Ali J, Qi W: The cardiorespiratory effects of increased intraabdominal pressure in diaphragmatic rupture. J Trauma 1992; 33: 233–239.

    Article  PubMed  CAS  Google Scholar 

  35. Baue AE: The particular problem of peritonitis and increased abdominal pressure. In: Baue AE (ed) Multiple Organ Failure. Patients Care and Prevention. St Louis, Mosby Year Book, 1990; 466–470.

    Google Scholar 

  36. Bloomfield GL, Ridings PC, Blocher CR, Marmarou A, Sugerman HJ: Effects of increased intra-abdominal pressure upon intracranial and cerebral perfusion pressure before and after volume expansion. J Trauma 1996; 40: 936–943.

    Article  PubMed  CAS  Google Scholar 

  37. Safran DS, Orlando R III: Physiologic effects of pneumoperitoneum. Am J Surg 1994; 167: 281–286.

    Article  PubMed  CAS  Google Scholar 

  38. Marathe US, Lilly RE, Slivestry SC, et al: Alterations in hemodynamics and left ventricular contractility during carbon dioxide pneumoperitoneum. Surg Endosc 1996; 10: 974–978.

    Article  PubMed  CAS  Google Scholar 

  39. Durham R, Neunaber K, Vogler G, Shapiro M, Mazuski J: Right ventricular end-diastolic volume as a measure of preload J Trauma 1995; 39: 218–224.

    CAS  Google Scholar 

  40. O’Leary E, Hbbard K, Torney W, Cunningham AJ: Laparoscopic cholecystectomy: haemodynamic and neuroendocrine responses after pneumoperitoneum and changes in position. Br J Anaesth 1996; 75: 640–644.

    Article  Google Scholar 

  41. Thaler W, Frey L, Marzoli P, Messmer K: Assessment of splanchnic tissue oxygenation by gastric tonometry in patients undergoing laparoscopic and open cholecystectomy. Br J Surg 1996; 83: 620–624.

    Article  PubMed  CAS  Google Scholar 

  42. Diebel LN, Dulchavsky SA, Brown WJ: Splanchnic ischemia and bacterial translocation in the abdominal compartment syndrome. J Trauma 1997; 43: 852–855.

    Article  PubMed  CAS  Google Scholar 

  43. Simon RJ, Friedlander MH, Ivatury RR, DiRaimo R, Machiedo GW: Hemorrhage lowers the threshold for intra-abdominal hypertension-induced pulmonary dysfunction. J Trauma 1997; 42: 398–405.

    Article  PubMed  CAS  Google Scholar 

  44. Ranieri VM, Brienza A, Santostasi S, et al: Impairment of lung and chest wall mechanics in patients with acute respiratory distress syndrome: role of abdominal distension. Am J Respir Crit Care Med 1997; 156: 1082–1091.

    Article  PubMed  CAS  Google Scholar 

  45. Fok TF, Ng PC, Wong W, Lee CH, So KW: High frequency oscillatory ventilation in infants with increased intra-abdominal pressure. Arch Dis Child 1997; 76: F123–F125.

    Article  CAS  Google Scholar 

  46. Irgau I, Koyfman Y, Tikellis JI: Elective intraoperative intracranial pressure monitoring during laparoscopic cholecystectomy. Arch Surg 1995; 130: 1011–1013.

    Article  PubMed  CAS  Google Scholar 

  47. Sugerman HJ, DeMaria EJ, Felton WL, Nakatsuka M, Sismanis A: Increased intra-abdominal pressure and cardiac filling pressures in obesity-associated pseudotumor cerebri. Neurology 1997; 49: 507–511.

    Article  PubMed  CAS  Google Scholar 

  48. Diebel L, Saxe J, Dulchavsky S: Effect of intra-abdominal pressure on abdominal wall blood flow. Am Surg 1992; 58: 573–576.

    PubMed  CAS  Google Scholar 

  49. Nathens A, Boulanger BR: The abdominal compartment syndrome. Curr Opin Crit Care 1998; 4: 118–120.

    Google Scholar 

  50. Savino JA, Cerabona T, Agarwal N, Byrne D: Manipulation of ascitic pressure in cirrhotics to optimize hemodynamic and renal function [discussion]. Ann Surg 1988; 208: 504–511.

    Article  PubMed  CAS  Google Scholar 

  51. Hirvonen EA, Nuutinen LS, Vuolteenaho O: Hormonal responses and cardiac filling pressures in head-up or head-down position and pneumoperitoneum in patients undergoing operative laparoscopy. Br J Anaesth 1997; 78: 128–133.

    Article  PubMed  CAS  Google Scholar 

  52. Rodríguez A, Egurrola A, Chiacchiara D, et al: Presion intraabdominal en pacientes criticos. Comparacion de dos metodos. Medi Intens (Argentina) 1995; 12: 51–55.

    Google Scholar 

  53. Sugrue M, Buist MD, Lee A, Sanchez DJ, Hillman KM: Intraabdominal pressure measurement using a modified nasogastric tube: description and validation of new technique. Intensive Care Med 1994; 20: 588–590.

    Article  PubMed  CAS  Google Scholar 

  54. Chang MC, Miller PR, D’Agostino R Jr., Meredith W: Effects of abdominal decompression on cardiopulmonary function and visceral perfusion in patients with intra-abdominal hypertension. J Trauma 1998; 44: 440–445.

    Article  PubMed  CAS  Google Scholar 

  55. Wittmann DH, Schein M, Condon RE: Management of secondary peritonitis. Ann Surg 1996; 224: 10–18.

    Article  PubMed  CAS  Google Scholar 

  56. Schein M, Hirshberg A, Hashmonai M: Current surgical management of severe intraabdominal infection. Surgery 1992; 112: 489–496.

    PubMed  CAS  Google Scholar 

  57. Wittmann DH, Aprahamian C, Bergstein JM, et al: A burr-like device to facilitate temporary abdominal closure in planned multiple laparotomies. Eur J Surg 1993; 159: 75–79.

    PubMed  CAS  Google Scholar 

  58. MacDonnell SP, Lalude OA, Davidson AC: The abdominal compartment syndrome: the physiological and clinical consequences of elevated intraabdominal pressure [letter]. J Am Coll Surg 1996; 184: 419–420.

    Google Scholar 

  59. Mayberry JC, Mullins RJ, Crass RA, Trunkey DD: Prevention of abdominal compartment syndrome by absorbable mesh prosthesis closure. Arch Surg 1997; 132: 957–962.

    Article  PubMed  CAS  Google Scholar 

  60. Ivatury RR, Porter JM, Simon RJ, Islam S, John R, Stahl WM: Intraabdominal hypertension after life-threatening penetrating abdominal trauma: prophylaxis, incidence, and clinical relevance to gastric mucosal pH and abdominal compartment syndrome. J Trauma 1998; 44: 1016–1023.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2000 Springer Science+Business Media New York

About this chapter

Cite this chapter

Bumaschny, E., Rodríguez, A. (2000). Abdominal Compartment Syndrome. In: Baue, A.E., Faist, E., Fry, D.E. (eds) Multiple Organ Failure. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1222-5_30

Download citation

  • DOI: https://doi.org/10.1007/978-1-4612-1222-5_30

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7049-2

  • Online ISBN: 978-1-4612-1222-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics