Síndrome

compartimental
abdominal
Daniela Burbano Jaramillo
Residente Cirugía General
Universidad de Caldas
 • Incidencia 29-34% en UCI
• SCA 3-6%
Epidemiología • Prevalencia: 56.8% - quirúrgico de emergencia vs 25.9% - cx
electiva
• Mortalidad 20-75%

Curr Opin Crit Care 2021, 27:164 – 168 DOI:10.1097/MCC.0000000000000797

The Journal of Critical Care Medicine 2018;4(4):114-119
Crit Care Med. 2019 Apr;47(4):535-542. doi: 10.1097/CCM.0000000000003623.
Smit et al. Ann. Intensive Care (2020) 10:130 https://doi.org/10.1186/s13613-020-00746-9
 Medición de la PIA
• Estándar PIV
• Fin de espiración
• Posición supina
• Sin contracción muscular – relajación
muscular
• Transductor en la línea axilar media sobre
cresta iliaca

• Normal: 5-7 mmHg

• Alerta: hasta 20 mmHg

• Cada 4-6 H
SDe Laet et al. Critical Care (2020) 24:97 https://doi.org/10.1186/s13054-020-2782-1
Rev Col Bras Cir 47:e20202415
 Clasificación

Rev Col Bras Cir 47:e20202415

The Journal of Critical Care Medicine 2018;4(4):114-119
 Definiciones

Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z

Intensive Care Med https://doi.org/10.1007/s00134-022-06780-4
Recomendaciones de la
guía
Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z
Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z
Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z
Van Damme and De Waele Critical Care (2018) 22:179 https://doi.org/10.1186/s13054-018-2103-0
Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z
Curr Opin Crit Care . 2017 Apr;23(2):159-166.
M. Sartelli et al. (eds.), Abdominal Sepsis, Hot Topics in Acute Care Surgery and Trauma, https://doi.org/10.1007/978-3-319-59704-1_1
Smith, J. W., Nash, N., Procter, L., Benns, M., Franklin, G. A., Miller, K., … Bernard, A. C. (2016). Not All Abdomens Are the Same: A Comparison of Damage Control Surgery for Intra-abdominal Sepsis versus Trauma. The American Surgeon, 82(5), 427–432.doi:10.1177/00031348160820051
Sugerencias de la guía
Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z
Am Surg. 2011 Jul;77 Suppl 1:S34-41.
Tasdogan, M., Memis, D., Sut, N., & Yuksel, M. (2009). Results of a pilot study on the effects of propofol and dexmedetomidine on inflammatory responses and intraabdominal pressure in severe sepsis. Journal of Clinical Anesthesia, 21(6), 394–400.doi:10.1016/j.jclinane.2008.10.010 
Hakobyan, R. V., & Mkhoyan, G. G. (2008). EPIDURAL ANALGESIA DECREASES INTRA ABDOMINAL PRESSURE IN POSTOPERATIVE PATIENTS WITH PRIMARY INTRA-ABDOMINAL HYPERTENSION. Acta Clinica Belgica, 63(2), 86–92.doi:10.1179/acb.2008.63.2.005 
Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z
Am Surg. 2011 Jul;77 Suppl 1:S34-41.
Cheatham, M. L., De Waele, J. J., De Laet, I., De Keulenaer, B., Widder, S., Kirkpatrick, A. W., … Puig, S. (2009). The impact of body position on intra-abdominal pressure measurement: A multicenter analysis*. Critical Care Medicine, 37(7), 2187–2190.doi:10.1097/ccm.0b013e3181a02132
Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z
 • Metoclopramdida o eritromicina
• Neostigmina

Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z

Am Surg. 2011 Jul;77 Suppl 1:S34-41.
Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z
Am Surg. 2011 Jul;77 Suppl 1:S34-41.
O’Mara, M. S., Slater, H., Goldfarb, I. W., & Caushaj, P. F. (2005). A Prospective, Randomized Evaluation of Intra-abdominal Pressures with Crystalloid and Colloid Resuscitation in Burn Patients. The Journal of Trauma: Injury, Infection, and Critical Care, 58(5), 1011–1018.doi:10.1097/01.ta.0000162732.390
Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z
Am Surg. 2011 Jul;77 Suppl 1:S34-41.
Latenser, B. A., Kowal-Vern, A., Kimball, D., Chakrin, A., & Dujovny, N. (2002). A Pilot Study Comparing Percutaneous Decompression With Decompressive Laparotomy for Acute Abdominal Compartment Syndrome in Thermal Injury. Journal of Burn Care & Rehabilitation, 23(3), 190–195.doi:10.1097/00004630-200205000-00008 
 Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z

Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z

Rev Col Bras Cir 47:e20202415
Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z
Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z
Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z
Intensive Care Med (2013) 39:1190–1206 DOI 10.1007/s00134-013-2906-z
 Paradigma
del
triángulo

De Laet et al. Critical Care (2020) 24:97 https://doi.org/10.1186/s13054-020-2782-1

 Abordaje práctico

Que tan urgente

Requiere requiere
Método?
intervención? disminución de
PIA?

De Laet et al. Critical Care (2020) 24:97 https://doi.org/10.1186/s13054-020-2782-1

Gracias