Abdominal compartment syndrome

Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines (World Society of the Abdominal Compartment Syndrome)[1]The World Society of the Abdominal Compartment Syndrome. WSACS consensus guidelines summary. Apr 2021 [internet publication]. https://www.wsacs.org/education/436/wsacs-consensus-guidelines-summary

An intra-abdominal pressure (IAP) greater than 12 mmHg indicates intra-abdominal hypertension, graded as follows:

• Grade I (12 to 15 mmHg)

• Grade II (16 to 20 mmHg)

• Grade III (21 to 25 mmHg)

• Grade IV (>25 mmHg).

A sustained IAP greater than 20 mmHg, with or without an abdominal perfusion pressure below 60 mmHg, with new-onset organ dysfunction or failure is diagnostic of ACS. World Society of the Abdominal Compartment Syndrome Opens in new window

In pediatric patients, the exact IAP that signals the transition from intra-abdominal hypertension to ACS is not currently known, but an IAP greater than 10 mmHg with new-onset organ dysfunction has been proposed for children.[8]De Waele JJ, Ejike JC, Leppäniemi A, et al. Intra-abdominal hypertension and abdominal compartment syndrome in pancreatitis, paediatrics, and trauma. Anaesthesiol Intensive Ther. 2015;47(3):219-27. http://czasopisma.viamedica.pl/ait/article/view/AIT.a2015.0027/28625 http://www.ncbi.nlm.nih.gov/pubmed/25973660?tool=bestpractice.com However, further research is needed to fully establish a threshold.