Criteria for a diagnosis of abdominal compartment syndrome.

摘要: We read with interest the recent case note by Vikrama and colleagues1 describing percutaneous management of a patient purported primary abdominal compartment syndrome (ACS). congratulate authors on their successful application less invasive technique for this potentially life-threatening injury. However, Executive Committee World Society Abdominal Compartment Syndrome (WSACS) would like to clarify several incorrect misleading statements in note. The author’s definition (ACS) is incorrect. According International Conference Experts Intra-Abdominal Hypertension Syndrome, intra-abdominal hypertension (IAH) defined as sustained or repeated pathologic elevation pressure (IAP) greater than equal 12 mm Hg.2,3 IAP 20 Hg that associated development new organ dysfunction failure. The authors’ description consistent IAH (IAP 26 Hg), but they fail define failure qualify diagnosis ACS. In addition, such should not be based upon single measurement rather increase can transiently elevated due coughing, agitation ventilator dyssynchrony. Further, whereas ACS classically considered disease traumatically injured patient, illustrated authors, / may also encountered medical pediatric patient-populations. presence among critically ill patients grossly underappreciated represents clinically important cause preventable morbidity mortality.3 The state “difficult” imply radiologic testing used identify IAP. These are inaccurate; easily accurately diagnosed use inexpensive bedside measurements those authors. literature replete studies demonstrating efficacy diagnostic accuracy measurements.3–5 Such diagnose direct ongoing therapeutic interventions. Radiologic tests unnecessary, expensive time-consuming, have poor sensitivity specificity Their routine tool only serves delay confuse appropriate ACS. The WSACS has described graded approach (www.wsacs.org) avoid need surgical decompression many patients.2,3 algorithm, drainage potential option before proceeding decompression. If unsuccessful reducing restoring adequate visceral perfusion setting ACS, immediately performed. clinical situation which “surgical feasible” treatment an effective rescue therapy, suggested exceedingly rare unlikely.