The Abdominal Compartment Syndrome PDF
Preview The Abdominal Compartment Syndrome
The Abdominal Compartment Syndrome Andre R. Campbell, MD, FACS, FACP, FCCM Professor of Surgery, UCSF Endowed Chair of Surgical Education San Francisco General Hospital Outline • Case presentations • Review literature • Abdominal Compartment Syndrome and Intra-Abdominal Hypertension • Suggest techniques that can be used to deal with these problems Damage Control Principles Damage Control Surgery Abdominal Compartment Syndrome Closure of the Abdomen Balogh Z et al. World J Surgery 2009 33:1134-41 Balogh Z et al. World J Surgery 2009 33:1134-41 Noosa Heads Australia December 2004 •170 leaders from around the world •Defined and updated the literature on this important clinical problem •Consensus definition were developed •Intraabdominal Hypertension occurred in 35% of ICU patients •Approximately 5% developed ACS Sugrue Curr Opin Crit Care 2005:11:333-338 Abdominal Compartment Syndrome Defined • Normal IAP is 5mm Hg • Can be non-pathological in the obese • mm Hg is the way to express the pressure • Measure at end expiration • No abdominal contractions • Gold standard intermittent indirect measurement is the bladder • Abdominal Perfusion Pressure(APP)= MAP – IAP Sugrue Curr Opin Crit Care 11:333-338, 2005 Abdominal Compartment Syndrome • Intra-Abdominal Hypertension: –IAP of 12mm Hg recorded 4-6 hours apart on three different occasions –A APP of 60 mm Hg or less recorded by a minimum standard measurements two times 1-6 hours apart
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