Define ACS clinically

 

Q: Clinically, Abdominal Compartment Syndrome (ACS) can be defined as Intra Abdominal Hypertension (IAH) induced new organ dysfunction without a strict intra-abdominal pressure (IAP) threshold? (select one)

A) True

B) False

Answer: A

Abdominal compartment syndrome (ACS) is a tricky business! Experts recommend different definitions for research and clinical purposes. 

For research reasons, ACS is defined as a sustained IAP above 20 mm Hg, with or without Abdominal Perfusion Pressure (APP) less than 60 mm Hg which is associated with new organ dysfunction. Formula for APP 

APP = MAP - IAP 

MAP = Mean arterial pressure 

Clinically there is no intra-abdominal pressure threshold and can be defined as IAH-induced new organ dysfunction without a strict intra-abdominal pressure threshold. Studies failed to correlate and predict intra-abdominal pressure with the diagnosis of ACS.

#surgical-critical-care

References:

1. Malbrain ML, Cheatham ML, Kirkpatrick A, et al. Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. I. Definitions. Intensive Care Med 2006; 32:1722. 

2.  Sugrue M. Abdominal compartment syndrome. Curr Opin Crit Care 2005; 11:333. 

3.  Malbrain ML, Deeren D, De Potter TJ. Intra-abdominal hypertension in the critically ill: it is time to pay attention. Curr Opin Crit Care 2005; 11:156. 

4. Cheatham ML, White MW, Sagraves SG, et al. Abdominal perfusion pressure: a superior parameter in the assessment of intra-abdominal hypertension. J Trauma 2000; 49:621.