You're listening to the podcast surgery ICU rounds.

My name's Dr. Jeffrey Guy.

I'm an associate professor of surgery at Vanderbilt University Medical Center in Nashville, Tennessee,

and I am the director of the Burns Center there.

Today, the topic that I would like to talk about is that of abdominal compartment syndrome.

Adominal compartment syndrome is the presence of elevated intradominal pressures,

and it's been commonly recognized as a factor contributing to the morbidity

and mortality of the critically ill and injured patient for quite some time.

The actual syndrome of abdominal compartment syndrome really occurs when the increased

intradominal pressure or the intradomal hypertension develops to the point where it causes

physiological embarrassment of several vital organs. For instance, decreased cardiac return

resulting in poor cardiac output, hypotension, respiratory embarrassment, and renal failure.

But a pair that increased intradominal pressure

is perhaps more common than many of us may have thought.

Epidemiological studies have found that in the critically ill patients,

the prevalence of increased intradominal

pressure or increased abdominal hypertension occurs between 2 and 33% of patients. Now, how do we

really define an increase in intradominal pressure? Well, it's really defined as an intradominal pressure greater than 20 millimeters of mercury.

And abdominal compartment syndrome, therefore, is defined as having increased intradominal pressure,

that is, an intradominal pressure greater than 20 millimeters of mercury, and one or more organs that have failed because of that increased interdominal pressure.

It's that second element, that end organ dysfunction, that's important,

because what happens is that people start getting into the notion of good number, bad number.

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