Evaluation and management of intraabdominal hypertension.

PURPOSE OF REVIEW: The purpose of this review is to provide an overview of the pathophysiology of intraabdominal hypertension/compartment syndrome and to review the recent advances in the areas of evaluation and management of this disorder.

RECENT FINDINGS: The incidence of intraabdominal hypertension (IAH) in intensive care units is as high as 45%, an incidence much higher than initially suspected. Despite decompressive laparotomy as a treatment, mortality in patients who developed abdominal compartment syndrome (ACS) requiring this procedure is as high as 50%. Some patients may be treated by fewer invasive methods, such as paracentesis, thereby avoiding the morbidity of laparotomy. Protective lung ventilation is key to managing the pulmonary sequalae of ACS. Point-of-care ultrasound can be used as an adjunctive decision-making tool.

SUMMARY: IAH is common in critically ill patients and portends a high mortality rate. Prevention and early recognition are key in minimizing adverse events.