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  • Abdominal Compartment Syndrome Guide

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    cusom34
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    This document discusses abdominal compartment syndrome (ACS). It defines ACS as organ dysfunction resulting from intra-abdominal hypertension where intra-abdominal pressure is greater than 20 mm Hg. ACS can be primary, from direct intra-abdominal pathology, or secondary from overaggressive resuscitation causing edema. Consequences of ACS include upward displacement of the diaphragm, decreased thoracic volume and oxygenation, compression of the IVC reducing venous return, and direct compression of the kidneys reducing renal function. The document provides examples of questions that could be asked to test understanding of ACS.

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    Abdominal Compartment Syndrome

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    Abdominal Compartment Syndrome

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    This document discusses abdominal compartment syndrome (ACS). It defines ACS as organ dysfunction resulting from intra-abdominal hypertension where intra-abdominal pressure is greater than 20 mm Hg. ACS can be primary, from direct intra-abdominal pathology, or secondary from overaggressive resuscitation causing edema. Consequences of ACS include upward displacement of the diaphragm, decreased thoracic volume and oxygenation, compression of the IVC reducing venous return, and direct compression of the kidneys reducing renal function. The document provides examples of questions that could be asked to test understanding of ACS.

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    © All Rights Reserved
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    8 просмотров23 страницы

    Abdominal Compartment Syndrome Guide

    Загружено:

    cusom34
    This document discusses abdominal compartment syndrome (ACS). It defines ACS as organ dysfunction resulting from intra-abdominal hypertension where intra-abdominal pressure is greater than 20 mm Hg. ACS can be primary, from direct intra-abdominal pathology, or secondary from overaggressive resuscitation causing edema. Consequences of ACS include upward displacement of the diaphragm, decreased thoracic volume and oxygenation, compression of the IVC reducing venous return, and direct compression of the kidneys reducing renal function. The document provides examples of questions that could be asked to test understanding of ACS.

    Авторское право:

    © All Rights Reserved
    Скачайте в формате PPTX, PDF, TXT или читайте онлайн в Scribd
    Отметить как неприемлемый контент
    из 23

    Abdominal Compartment Syndrome

    Reza Afrasiabi, PGY4


    PSJH
    11/30/2018
    Abdominal Compartment Syndrome (1/3)
    • Organ dysfunction that results from intraabdominal hypertension (IAH)

    • IAH = intra-abdominal pressure (IAP) > 20 mm Hg

    • IAP must be measured at the end of expiration in a relaxed patient

    • IAP – measured via bladder pressures (i.e. intravesical pressure)


    Abdominal Compartment Syndrome (2/3)
    • Causes:

    • Primary ACS: result of IAH brought on by intra-abdominal pathology


    (ileus, retroperitoneal hemorrhage, ascites, pneumoperitoneum, liver
    transplantation, etc)

    • Secondary ACS: result of overaggressive resuscitation and/or edema


    that results from ischemia/sepsis
    Abdominal Compartment Syndrome (3/3)
    • Consequences:
    • Upward displacement of diaphragm resulting in decreased thoracic
    volume, increased intrapleural pressure resulting in hypoxia,
    hypercapnia and acidosis

    • Compression of IVC resulting in decreased venous return, decreased


    preload and hence decreased cardiac output

    • Direct compression of kidneys resulting in obstruction of renal venous


    outflow, decrease in GFR and hence decreased UOP.
    A Picture Is Worth A 1000 Words
    ACS Question #1
    ACS Question #1
    ACS Question #2
    ACS Question #2
    ACS Question #3
    ACS Question #3
    Peak and Plateau Airway Pressures

    • Resistance Pressure: pressure needed


    to get air into lungs

    • Plateau Pressure: pressure needed to


    keep air in lungs

    • Normal Peak Pressure = 25-30 cm H2O


    • Question 1: Patient with Peak Airway Pressure of 60 cm H2O, but Plateau
    Pressure of 20 cm H2O. What’s going on?

    • Question 2: Patient with Peak Airway Pressure of 60 cm H2O and Plateau


    Pressure of 55 cm H2O. What’s going on?
    ACS Question #4
    ACS Question #4
    ACS Question #5
    ACS Question #5

    Very high index of suspicion for developing abdominal compartment syndrome.


    Monitor bladder pressures and UOP closely.
    ACS Question #6
    ACS Question #6

    This patient has abdominal compartment syndrome. Pressure must be relieved-


    must open abdomen!
    ACS Question #7
    ACS Question #7

    Patient needs temporary abdominal closure- Abthera, etc


    Questions?

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