Category: Critical Care
Keywords: ACS, abdominal compartment syndrome, intraabdominal hypertension, emergent laparotomy (PubMed Search)
With ED-boarding of critically-ill patients becoming more common, it is likely that ED physicians may find themselves caring for a patient who develops ACS – that is, abdominal compartment syndrome. While intraabdominal hypertension (IAH) is common and is defined as intraabdominal pressure > 12 mmHg, ACS is defined as a sustained intraabdominal pressure > 20mmHg with associated organ injury.
WHY you need to know it:
ACS → Increased mortality & recognition is key to appropriate management
WHO is at risk:
HOW it kills:
→ Lactic acidosis, respiratory acidosis, multisystem organ failure, cardiovascular collapse & death
WHEN to consider it:
WHAT to do:
Bottom Line: Abdominal compartment syndrome is an affliction of the critically ill, is assosciated with worsened mortality, and requires aggressive measures to lower the intraabdominal pressure while obtaining emergent surgical consultation for potential emergent laparotomy.
Gottlieb M, Koyfman A, Long B. Evaluation and Management of Abdominal Compartment Syndrome in the Emergency Department. J Emerg Med. 2019. https://doi.org/10.1016/j.jemermed.2019.09.046