Abdominal compartment syndrome and acute intestinal distress syndrome

作者：Sanchez Miralles A; Castellanos G; Badenes R; Conejero R^*

来源：Medicina Intensiva, 2013, 37(2): 99-109.

DOI：10.1016/j.medin.2011.11.019

• Intra-abdominal pressure
• Abdominal compartment syndrome
• Intra-abdominal hypertension
• Acute intestinal distress syndrome

Seriously ill patients frequently present intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) as complications, and the associated mortality is very high. This review offers an update on the most controversial aspects of these entities: factors favoring their appearance, the most common causes, prognosis, and methods of measuring intra-abdominal pressure (IAP), physiopathological consequences in relation to the different organs and systems, and the currently accepted treatment measures (medical and/or surgical). Simultaneously to the strictly physical mechanisms of injury, such as direct compression of intra-abdominal organs and vessels, the transmission of IAP to other compartments, and the drop in cardiac output, a series of immune-inflammatory mediators generated in the intestine itself may also intervene. Hypoperfusion, sustained ischemia and the ischemia-reperfusion phenomenon, would act upon the microbiota, intestinal epithelium and intestinal immune system, triggering a systemic inflammatory response and multiorgan dysfunction that appears in the final stages of ACS.

• 出版日期2013-3