Table 2 Adverse effects of intra abdominal hypertension (IAH) and abdominal compartment syndrome (ACS)
From: Management of intra-abdominal hypertension and abdominal compartment syndrome: a review
| Cerebral | • An Increase in IAP forces the diaphragm up decreasing intra-thoracic space, increasing the intra-thoracic pressure. |
| • Jugular venous pressure elevates. | |
| • Venous return decreases. | |
| • Intra cerebral pressure will increase. | |
| • Cerebral blood flow decreases. | |
| Cardiac function | • An increase in IAP causes increased pressure on the inferior vena cava, intra abdominal circulation and perfusion. |
| • Venous return is impaired and peripheral oedema occurs. | |
| • Increase in central venous pressure. | |
| • Increased pulmonary artery wedge pressures as the myocardium is placed under an increasing workload. | |
| Respiratory function | • An increased in IAP forces the diaphragm up decreasing intra-thoracic space and restricts respiration. |
| • Result in an increase in intra thoracic pressure particularly with mechanically ventilated patients. | |
| • Left uncorrected will result in a decrease in lung compliance, functional residual capacity a VQ mismatch and hypoxia. | |
| Renal function | • Defined as oliguria and anuria despite aggressive fluid resuscitation. |
| • Increase in abdominal pressure decreases renal blood flow coupled with a reduction in cardiac output. | |
| • The rennin angiotensin system is activated further adding to intra- abdominal pressure and cardiac workload. | |
| Gastrointestinal function | • Increased intra- abdominal pressure results in an increase in vascular resistance and decreased cardiac output. |
| • Results in a decrease in tissue perfusion. | |
| • Ultimately tissue ischemia. | |
| Peripheral perfusion | • Increased intra- abdominal pressure is said to increase femoral venous pressure increase peripheral vascular resistance and reduce femoral artery blood flow by up to 60%. |