Abdominal compartment syndrome among surgical patients

Table 1 Intra-abdominal hypertension grading[2]

Grade	Intra-abdominal pressure
Grade I	12-15 mmHg
Grade II	16-20 mmHg
Grade III	21-25 mmHg
Grade IV	> 25 mmHg

Table 2 Pathophysiologic changes and end-organ effect of intra-abdominal hypertension

System	IAH mechanism of adverse effects	End-organ effect
Central nervous system[42]	Obstruction of venous outflow	Increase in intracranial pressure
	Increase in jugular venous pressure	Decrease in cerebral perfusion pressure
	Increase in inflammatory markers with disruption of the blood-brain barrier
	Decrease lumbar venous plexus blood flow
	-Increase cerebral blood flow
Cardiovascular system[43]	Elevation of diaphragm and elevation in intrathoracic pressure with cardiac compression	Increase in right ventricular afterload
	Compression of inferior vena cava	Decrease in cardiac output
		Decrease in ventricular compliance/contractility
Pulmonary system[36,44]	Pulmonary compression	Increase in peak airway pressure
	Alveolar atelectasis	Increase in plateau pressure
	Decreased pulmonary capillary blood flow	The decrease in pulmonary compliance
	Lymphatic drainage impairment	A decrease in tidal volume
		A decrease in functional residual capacity
		Ventilation-perfusion mismatch
		Hypercarbia
		Lung edema
Gastrointestinal system[12]	Direct impairment of arterial and venous blood flow	Ileus
	Intestinal perfusion impairment	Bowel edema
	Obstruction of lymphatic flow	Bowel ischemia
		Bacteria translocation
		Lactatemia
		Decrease gastric intramucosal pH
Renal system[45,46]	Renal artery and vein compression	A decrease in filtration gradient
	Parenchymal compression	Oliguria
	Glomerular and tubular function impairment	Acute renal failure
	Activation of the renin-angiotensin system
Vascular system[47]	Increased systemic vascular resistance	Peripheral edema
	Inferior vena cava compression	Venous stasis
		Increase the risk of venous thrombosis

IAH: Intra-abdominal hypertension.