From the classroom to the emergency room, OR and beyond.

You're joining trauma ICU rounds with your host, Dr. Dennis Kim.

I'd like to welcome you back to trauma ICU rounds.

I'm your host, Dr. Dennis Kim.

By request, today on rounds, we're discussing intra-abdominal hypertension and the abdominal compartment syndrome, or ACS.

Now, as you may have noticed, the underlying theme for much of season one for trauma ICU rounds has been the ABCs of trauma and critical care,

from airway management to shock, ECMO, EPR, and everything in between.

And although ACS may not initially seem to be congruent with other episodes this season,

my hope is that by the end of rounds, you have a deeper appreciation for the widespread systemic

and hemodynamic consequences of intra-abdominal hypertension, as well as abdominal compartment

syndrome, which are not limited simply to intra-abdominal organs or viscera.

Although, once perceived as having a primarily mechanical pathogenesis whereby the physical

capacitance of the abdominal envelope or container was exceeded, we now appreciate that the host of deleterious

effects that accompany the syndrome are, in fact, enacted systemically through the generation

of biomediators, inflammatory cytokines, which result in multiple organ dysfunction

syndrome through polycompartmental pressure interactions. And for me personally,

this is what makes this topic a lot of fun to discuss. When patients develop the syndrome,

they're not only at risk for splanknic or renal hypopofusion, but also cardiorespiratory

compromise or distress due to the effect of increased abdominal compartment pressures on pulmonary

compliance, respiratory system mechanics, as well as cardiovascular preload, stroke

volume, afterload, and eventually cardiac output and the map.

Therefore, it's important for any and all of us caring for critically ill or injured patients

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