Ch. 33 - 1

Question 1

is defined as end-organ dysfunction caused by intraabdominal hypertension (IAH)
Increased pressure can be caused by bleeding, ileus, mesenteric edema, or a noncompliant abdominal wall. Increased pressure within the abdominal cavity can impinge on diaphragmatic excursion and can affect ventilation.
Clinical manifestations of abdominal compartment syndrome include decreased cardiac output, decreased tidal volume, increased peak pulmonary pressure, decreased urine output, and hypoxia.
can be measured through various commercially available devices or a simple pressurized tubing setup. In both instances, the urinary bladder acts as a transducer to estimate the degree of IAP after the injection of 25 mL of sterile saline. IAH is defined as an IAP greater than or equal to 12 mm Hg (normal 5 to 7 mm Hg).
IAH grade I (12 to 15 mm Hg)
IAH grade II (16 to 20 mm Hg)
IAH grade III (21 to 25 mm Hg)
IAH grade IV (greater than 25 mm Hg)
Surgical decompression of the abdomen may be required for abdominal pressures greater than 20 to 25mm Hg accompanied by a taut, tense abdomen and signs of organ dysfunction such as deteriorating heart, lung, and kidney status.
patient may return to the critical care unit with an “open abdomen”
Wound is closed permanently in the days or weeks following the surgery or, depending on its size, may be allowed to heal by secondary intention and eventual skin grafting

Answer 1

Abdominal Compartment Syndrome