Abdominal Compartment Syndrome: Definitions, Epidemiology, and Management

Abstract

Abdominal compartment syndrome (ACS) is a multifaceted and potentially life-threatening medical condition characterized by elevated intra-abdominal pressure. While ACS was initially associated with trauma, it has become evident that this syndrome can manifest in various clinical scenarios. The prevalence of ACS varies across diverse patient populations and clinical settings. Risk factors such as obesity, intra-abdominal tumors, ascites, and major surgery heighten the vulnerability to developing ACS. The pathophysiology of ACS involves a cascade of events compromising organ perfusion. This includes the compression of the inferior vena cava and renal veins, leading to reduced venous return and impaired renal blood flow, which can result in renal failure. Accurate diagnosis of ACS relies on the measurement of intra-abdominal pressure, often performed through bladder pressure measurement. Management encompasses a range of supportive measures, careful patient positioning, ventilatory support, and strategies to reduce intra-abdominal volume. Surgical decompression becomes necessary when conservative approaches fail, although this decision must consider individual patient factors. This review underscores the evolving landscape of ACS and emphasizes the imperative for continued research to address uncertainties in pathophysiology, diagnostic criteria, and management strategies. Enhanced understanding and refined approaches hold the potential to significantly improve outcomes for at-risk or affected patients.