Abdominal Compartment Syndrome Guidelines

Updated: Jan 30, 2023
  • Author: Richard Paula, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Guidelines Summary

WSACS guidelines

The World Society of the Abdominal Compartment Syndrome has published the following definitions and recommendations [2, 16, 24] :

  • 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.
  • Patients should be screened for IAH/ACS risk factors upon ICU admission and in the presence of new or progressive organ failure.
  • APP should be maintained above 50-60 mm Hg in patients with IAH/ACS [Abdominal perfusion pressure (APP) = mean arterial pressure (MAP) – IAP].
  • Fluid resuscitation volume should be carefully monitored to avoid overresuscitation in patients at risk for IAH/ACS.
  • Hypertonic crystalloid and colloid-based resuscitation should be considered in patients with IAH to decrease the progression to secondary ACS.
  • Surgical decompression should be performed in patients with ACS that is refractory to other treatment options.
  • Presumptive decompression should be considered at the time of laparotomy in patients who demonstrate multiple risk factors for IAH/ACS.