Balogh Zsolt J, Malbrain Manu
Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW 2130, Australia.
Am Surg. 2011 Jul;77 Suppl 1:S31-3.
Resuscitation and the development of abdominal compartment syndrome (ACS) are closely associated and frequently overlapping critical care topics. Elevated intra-abdominal pressure (IAP) can cause major deterioration of cardiac function by affecting preload, contractility, and afterload. Pathologically elevated IAPs are often compounded by the presence of shock leading to imminent organ failure. Excessive or overzealous resuscitation in an attempt to restore perfusion and correct these organ dysfunctions and failures can worsen elevated IAP and increase the risk of ACS. The aim of this review is to discuss these multilevel interactions between resuscitation and ACS identifying appropriate resuscitative strategies for the patient with elevated IAP.
复苏与腹腔间隔室综合征(ACS)的发展密切相关,且是重症监护中经常重叠的关键主题。腹内压(IAP)升高可通过影响前负荷、收缩力和后负荷导致心脏功能严重恶化。病理性IAP升高常因休克的存在而加重,进而导致即将发生的器官衰竭。为恢复灌注并纠正这些器官功能障碍和衰竭而进行的过度或过激复苏,会使升高的IAP恶化,并增加ACS的风险。本综述的目的是讨论复苏与ACS之间的这些多层次相互作用,为IAP升高的患者确定合适的复苏策略。