Łagosz Piotr, Sokolski Mateusz, Biegus Jan, Tycinska Agnieszka, Zymlinski Robert
Department of Heart Diseases, Wroclaw Medical University, Wroclaw 50-367, Poland.
Department of Cardiology, Medical University of Bialystok, Bialystok 15-089, Poland.
World J Clin Cases. 2022 Apr 6;10(10):3005-3013. doi: 10.12998/wjcc.v10.i10.3005.
Elevated intra-abdominal pressure (IAP) is a known cause of increased morbidity and mortality among critically ill patients. Intra-abdominal hypertension (IAH) and abdominal compartment syndrome can lead to rapid deterioration of organ function and the development of multiple organ failure. Raised IAP affects every system and main organ in the human body. Even marginally sustained IAH results in malperfusion and may disrupt the process of recovery. Yet, despite being so common, this potentially lethal condition often goes unnoticed. In 2004, the World Society of the Abdominal Compartment Syndrome, an international multidisciplinary consensus group, was formed to provide unified definitions, improve understanding and promote research in this field. Simple, reliable and nearly costless standardized methods of non-invasive measurement and monitoring of bladder pressure allow early recognition of IAH and timely optimized management. The correct, structured approach to treatment can have a striking effect and fully restore homeostasis. In recent years, significant progress has been made in this area with the contribution of surgeons, internal medicine specialists and anesthesiologists. Our review focuses on recent advances in order to present the complex underlying pathophysiology and guidelines concerning diagnosis, monitoring and treatment of this life-threatening condition.
腹内压升高(IAP)是危重症患者发病率和死亡率增加的已知原因。腹腔内高压(IAH)和腹腔间隔室综合征可导致器官功能迅速恶化并引发多器官功能衰竭。升高的IAP会影响人体的每个系统和主要器官。即使是轻度持续的IAH也会导致灌注不良,并可能扰乱恢复过程。然而,尽管这种情况很常见,但这种潜在的致命状况往往未被注意到。2004年,国际多学科共识组织腹腔间隔室综合征世界协会成立,旨在提供统一的定义,增进对此领域的理解并促进该领域的研究。简单、可靠且几乎无成本的非侵入性测量和监测膀胱压力的标准化方法可实现IAH的早期识别和及时的优化管理。正确、结构化的治疗方法可产生显著效果并完全恢复内环境稳定。近年来,在外科医生、内科专家和麻醉医生的共同努力下,该领域取得了重大进展。我们的综述聚焦于近期进展,以便阐述这种危及生命状况的复杂潜在病理生理学以及有关诊断、监测和治疗的指南。