What is abdominal compartment syndrome (ACS)?

Organ failure caused by excessive intra-abdominal pressure (> 12 mm Hg) which decreases preload and increases afterload, leading to decreased end-organ oxygen perfusion.

Three forms of ACS:

1. Primary: stems from hemorrhage
   
2. Secondary: associated with vigorous volume resuscitation with the acute formation of ascites as well as visceral edema. Increasingly common after initiation of early goal directed therapy for sepsis.
   
3. Recurrent: an ACS that recurs secondary to extravasation of fluid via loss of capillary integrity caused by end organ ischemia

Treatment:

1. Treat underlying cause
   
2. Decompressive laparatomy with temporary abdominal wall closure if option 1 not enough

Source

Maerz, L et al. "Abdominal compartment syndrome" Crit Care Med 2008.