Intra-Abdominal Hypertension (IAH). &. Abdominal Compartment Syndrome (ACS). By: Tim Wolfe, MD Email: email@example.com. What was their intra-abdominal pressure?. Have you ever seen a critically ill patient become progressively more swollen and edematous after fluid resuscitation?
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Abdominal CompartmentSyndrome (ACS)
By: Tim Wolfe, MD
5 y.o. female presenting with septic syndrome
DeCou, J Ped Surg 2000
67 y.o. female presenting to ER with pleurisy, dyspnea
Etzion, Am J EM 2004
77 y.o. male aspirated on general medicine floor. Transferred to MICU & intubated; hypotensive.
Cheatham, WSACS 2006
Pressure (mm Hg) Interpretation
5-10 Common in most ICU patients
> 12 (Grade I) Intra-abdominal hypertension
16-20 (Grade II) Dangerous IAH - begin non-
>21-25 (Grade III) Impending abdominal compartment
syndrome - strongly consider
(Including bowel wall and mesentery)
Where does all that fluid go?
(Multi-System Organ Failure)
Decreased O2 delivery
Free radical formation
APP = MAP – IAP
Bladder pressure monitoring through the Foley catheter is:
Assembled sterilely in proper fashion
Commercially available devices :
Advantages – Simple, standardized, reproducible, time-efficient, sterile
Closed system in-line with the Foley catheter
Do NOT wait for signs of ACS to check IAP
Monitor ALL high risk patients early and often:
IAH and ACS Educational Web sites:
Video to review concepts of monitor set-up: