"Patients present with one or more organs failing due to elevated intra-abdominal pressure, with direct or indirect effects on major body systems. Most patients will have abdominal distension. Patients often have multifactorial diseases and injuries, and abdominal compartment syndrome is particularly associated with 2,8:"
"The ratio of maximal anteroposterior to transverse abdominal diameter (>0.8) and the peritoneal to abdominal height ratio (PAR ≥0.52) in CT seem to be statistically associated with elevated intra-abdominal pressure in critically ill patients 6. Several other overlapping CT and sonographic signs may support the diagnosis, but none are considered sensitive or specific for abdominal compartment syndrome 2,4,8,11:"
"systematic six-position scan using a low-frequency convex transducer: epigastric, peri-umbilical, bilateral lower quadrants, bilateral subdiaphragmatic, and suprapubic regions"
"Doppler abnormalities: reduced or reversed end-diastolic flow in portal, hepatic, and renal veins; elevated renal arterial resistive index in 66%"
"Mortality in abdominal compartment syndrome remains high, ranging from 39-55% in contemporary series, with adjusted mortality odds ratios of 3.84-21.85 compared to critically ill patients without ACS 11."
Expected headings
"Complications"
"Abdominal compartment syndrome is formally defined as a persistently elevated intra-abdominal pressure >20 mmHg with concomitant organ dysfunction or failure. Abdominal perfusion pressure (APP) is a supplementary measurement; values"
"vascular compression: flattened IVC (below renal veins) and renal veins; IVC diameter reduced ~10%, cross-sectional area reduced ~25% 1"
"Doppler abnormalities: reduced or reversed end-diastolic flow in portal, hepatic, and renal veins; elevated renal arterial resistive index in 66%"
"fluids, diuresis or dialysis to achieve euvolemia 9"