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Damage Control in Abdominal Compartment Syndrome

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Severe Trauma and Sepsis

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Abstract

Abdominal compartment syndrome (ACS) is the endpoint of increased intra-abdominal pressure (IAP) which is the result of massive interstitial swelling in the abdomen or rapid development of a space-filling lesion within the abdomen. The intra-abdominal hypertension (IAH) leads to decreased abdomen perfusion pressure (APP) resulting in abdominal viscera dysfunction contributing to multi-organ dysfunction (MOD) and ischemia which lead to high mortality. Measurement has been taken to monitor the IAP for the contradiction between resuscitation and the massive interstitial swelling which lead to IAH. Besides the monitor measurements, damage control was introduced to save the severely injured patients who are on the edge of physiological limit. Damage control resuscitation and damage control surgery were conducted to maintain the balance among physiological limit, resuscitation, and controllable IAP. There is minimal original article about the pathophysiology of ACS. Most results were from clinical trial. Many early studies of IAH and ACS used discordant definitions or cutoff pressure values. In this review, nomenclature will follow the terminology established by the World Society of the Abdominal Compartment Syndrome (WSACS) which has recently been standardized and accepted widely. This chapter reviewed the history and the pathophysiology of ACS and the application of damage control.

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Abbreviations

ACS:

Abdominal compartment syndrome

APP:

Abdominal perfusion pressure

ATLS:

Advanced trauma life support

IAH:

Intra-abdominal hypertension

IAP:

Intra-abdominal pressure

ICU:

Intensive care unit

MAP:

Mean arterial pressure

MTP:

Massive transfusion protocol

OA:

Open abdomen

PCD:

Percutaneous catheter drainage

PEEP:

Positive end-expiratory pressure

PPV:

Pulse pressure variation

TAC:

Temporary abdominal closure

tPA:

Tissue plasminogen activator

WSACS:

World Society of the Abdominal Compartment Syndrome

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Author information

Authors and Affiliations

  1. Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China

    Cheng Zhao & Jianan Ren

Authors
  1. Cheng Zhao
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  2. Jianan Ren
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Editor information

Editors and Affiliations

  1. Wound Healing and Cell Biology Lab, First Affiliated Hospital, Chinese PLA General Hospital, Beijing, China

    Xiaobing Fu

  2. State Key Laboratory of Trauma, Burns, and Combined Injury, Daping Hospital, Third Military Medical University, Chong Qing, China

    Liangming Liu

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Zhao, C., Ren, J. (2019). Damage Control in Abdominal Compartment Syndrome. In: Fu, X., Liu, L. (eds) Severe Trauma and Sepsis. Springer, Singapore. https://doi.org/10.1007/978-981-13-3353-8_1

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  • DOI: https://doi.org/10.1007/978-981-13-3353-8_1

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  • Publisher Name: Springer, Singapore

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  • Online ISBN: 978-981-13-3353-8

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