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Review
. 2019 Dec 19:12:1061-1074.
doi: 10.2147/JMDH.S205608. eCollection 2019.

Abdominal Compartment Syndrome: Improving Outcomes With A Multidisciplinary Approach - A Narrative Review

Martin Padar  1   2 , Annika Reintam Blaser  2   3 , Peep Talving  4   5 , Edgar Lipping  6 , Joel Starkopf  1   2
Affiliations
Review

Abdominal Compartment Syndrome: Improving Outcomes With A Multidisciplinary Approach - A Narrative Review

Martin Padar et al. J Multidiscip Healthc. .

Abstract

Abdominal compartment syndrome (ACS) refers to a severe increase in intra-abdominal pressure associated with single or multiorgan failure. ACS with specific pathophysiological processes and detrimental outcomes may occur in a variety of clinical conditions. Patients with ACS are predominantly managed in critical care settings, however, a wide range of multidisciplinary interventions are frequently required from medical, surgical, radiological and nursing specialties. The medical management, aiming to prevent the progression of intra-abdominal hypertension to ACS, is extensively reviewed. Timing and techniques of surgical decompression techniques, as well as management of open abdomen, are outlined. In summary, the current narrative review provides data on history, definitions, epidemiology and pathophysiology of the syndrome and highlights the importance of multidisciplinary approach in the management of ACS in adults.

Keywords: abdominal compartment syndrome; abdominal decompression; damage control surgery; decompressive laparotomy; intra-abdominal hypertension; open abdomen.

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Conflict of interest statement

Dr Annika Reintam Blaser reports personal fees from Nestlé, personal fees from Fresenius Kabi, grants from Fresenius Kabi, outside the submitted work. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Estimated prevalence and mortality of different grades of IAH and of ACS. Note: Data from Iyer et al, Murphy et al, and Reintam Blaser et al. Abbreviations: IAH, intra-abdominal hypertension; ACS, abdominal compartment syndrome.
Figure 2
Figure 2
Nonsurgical management of IAH and ACS. Note: Data from Kirkpatrick et al and Starkopf et al Abbreviations: IAP, intra-abdominal pressure; IAH, intra-abdominal hypertension; ACS, abdominal compartment syndrome.
Figure 3
Figure 3
A clinical image of a patient with aortic injury subjected to damage control laparotomy with temporary abdominal closure using negative pressure wound therapy (NPWT). Note: Photo courtesy of Peep Talving.
Figure 4
Figure 4
A clinical image of a patient with peritonitis and abdominal compartment syndrome subjected to fascial closure with negative pressure wound dressing and the ABRA system (Dynamic tissue systems, Barrie, Ontario, Canada). Note: Photo courtesy of Peep Talving.
Figure 5
Figure 5
Clinical images of a patient subjected to split-thickness skin graft as a temporary abdominal closure after achieving successful treatment of enteroatmospheric fistulas, and to definitive fascial closure after 3 months. Note: Photo courtesy of Peep Talving.
See this image and copyright information in PMC

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