Abdominal Compartment Syndrome Guidelines

Updated: Aug 21, 2017
  • Author: Richard Paula, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Guidelines Summary

The World Society of the Abdominal Compartment Syndrome has published the following definitions and recommendations [3] :

  • Intra-abdominal pressure is approximatley 5-7 mm Hg in critically ill adults.
  • Intra-abdominal hypertension is defined by a sustained or repeated pathological elevation in IAP of ≥12 mm Hg.
  • ACS is defined as a sustained IAP >20 mm Hg associated with organ dysfunction/failure.
  • IAH is graded as follows: Grade I: IAP 12-15 mm Hg;  Grade II: IAP 16-20 mm Hg; Grade III: IAP 21-25 mm Hg; Grade IV: IAP >25 mm Hg.
  • Recommend measuring intra-abdominal pressure when any know risk factor for IAH/ACS is present in critically ill or injured patients.
  • Recommend that studies of IAH or ACS adopt the trans-bladder technique as a standard IAP measurement technique.
  • Recommend decompressive laparotomy to decrease IAP in cases of overt ACS.
  • Suggest brief trials of neuromuscular blockade as temporizing measure in treatment of IAH.