Abdominal compartment syndrome

A high index of suspicion should be maintained in all patients with risk factors for elevated intra-abdominal pressure (IAP). The aim is to identify and treat intra-abdominal hypertension before it can progress to ACS. Patients at risk should be identified and protocolised monitoring of IAP instigated early. Excess fluid administration is the most common cause and can be avoided if appropriate endpoints of resuscitation are accurately assessed. Global endpoints include vital signs, cardiac output, pulmonary artery wedge pressure, lactate, and the base deficit. Local endpoints allow assessment of tissue-specific perfusion and include gastric tonometry and near-infrared spectroscopy.