Abdominal compartment syndrome: Current concepts and management

Abdominal compartment syndrome occurs when 2 or more anatomic compartments have a sustained intra-abdominal pressure >20mmHg, associated with organ failure. Incidence is 2% and prevalence varies from 0% to 36.4%. A literature search was conducted utilizing different databases. Articles published from 1970 to 2018 were included, in English or Spanish, to provide the concepts, classifications, and comprehensive management in the approach to abdominal compartment syndrome, for its treatment and the prevention of severe complications associated with the entity. Intravesical pressure measurement is the standard diagnostic method. Treatment is based on evacuation of the intraluminal content, identification and treatment of intra-abdominal lesions, improvement of abdominal wall compliance, and optimum administration of fluids and tissue perfusion. Laparotomy is generally followed by temporary abdominal wall closure 5–7 days after surgery. Reconstruction is performed 6–12 months after the last operation. Abdominal compartment syndrome should be diagnosed and operated on before organic damage from the illness occurs. Kidney injury can frequently progress and is a parameter for considering abdominal decompression. Having a biomarker for early damage would be ideal. Surgical treatment is successful in the majority of cases. A multidisciplinary focus is necessary for the intensive care and reconstructive needs of the patient. Thus, efforts must be made to define and implement strategies for patient quality of life optimization. El síndrome compartimental abdominal se define cuando 2 o más compartimentos anatómicos tienen una presión intraabdominal con valor sostenido >20mmHg, asociado a una falla orgánica. La incidencia es del 2% y la prevalencia del 0 al 36.4%. Se realizó la búsqueda bibliográfica en diferentes bases de datos. Se incluyeron artículos publicados desde 1970 al 2018, en inglés o español, con el fin de proporcionar los conceptos, clasificaciones y manejo integral en el abordaje del síndrome compartimental, para tratar y evitar complicaciones severas en los pacientes asociados a dicha entidad. La medición de la presión intravesical es el método estándar para el diagnóstico. El tratamiento se basa en la evacuación de contenidos intraluminales, identificar y tratar las lesiones intraabdominales, mejorar la complianza de la pared abdominal, y la óptima administración de fluidos y perfusión tisular. La laparotomía es generalmente seguida de un cierre temporal