All of the following are true about abdominal compament syndrome except:
ABDOMINAL COMPAMENT SYNDOME - ACS is defined as increased intra-abdominal pressure (IAP > 20mm Hg) resulting in compression of abdominal structures, producing fatal complications due to pulmonary failure and mesenteric vascular compromise. - Normal IAP = 5-7 mm Hg: intra-abdominal hypeension IAP >= 12 mm Hg - ACS occurs predominantly in: - Patients in profound shock: - Patients requiring large amounts of resuscitation fluids & blood - Those with major visceral or vascular abdominal injuries -IVC compresed -Decreased Venous return- Decrease Cardiac Output - Decrease systolic blood pressure - Decrease renal blood flow & vascular blood flow - decrease GFR - decrease urine output. Physiologic consequences of increased intra-abdominal Pressure Decreased Increased - Cardiac output - Central venous return - Visceral blood flow - Renal blood flow - Glomerular filtration - Cardiac rate - Pulmonary capillary wedge pressure - Peak inspiratory pressure - Central venous pressure - Intrapleural pressure - Systemic vascular resistance Abdominal Compament syndrome grading system Grade Bladder pressure (mm Hg) Clinical features Treatment I 12-15 None Normovolemic resuscitation II 16-20 Oliguria, splanchnic hypoperfusion Hypovolemic resuscitation III 21-25 Anuria, increased ventilation pressure Decompression IV > 25 Anuria, increased ventilation pressure & decreased PO2 Emergency re-exploration
Trauma
Characterized by a increased peak inspiratory pressure, decreased urinary output
Can lead to fatal complications due to pulmonary failure and mesenteric vascular compromise
A urinary bladder catheter is the gold standard indirect method used to measure IAP
Grade III abdominal compament syndrome is managed by hypovolemic resuscitation
Grade III abdominal compament syndrome is managed by hypovolemic resuscitation