True about intra abdominal compament syndrome -
Ans is 'a' i.e. Intraabdominal pressure > 15 cm H2O Abdominal Compament syndrome Is caused by acute increase in the intraabdominal pressure, caused by accumulation of large amounts of fluid i.e. blood or edema It is seen in patients -who have sustained massive abdominal trauma had an operation for massive intraabdominal infection or undergone a complicated prolonged abdominal operation The Normal intraabdominal pressure (IAP) is nearly 0 cm of H20 and large amounts of fluid accumulation is needed before it begin to rise. When the IAP exceeds 15 cm F120, serious physiological changes begin to occur. The lungs are compressed by the upward displacement of the diaphragm. This causes a decrease in functional residual capacity, increased airway pressure, and ultimately hypoxia. a) - Cardiac output decreases due to diminished venous return to the hea and increased afterload. - Both venous return and aerial perfusion of every intraabdominal organ especially kidneys are severely compromised. This leads to oliguria which may progress to anuria. As IAP exceeds 25 to 30 cm of H2O life threatening hypoxia and anuric renal failure occurs. Physiological Consequences of Increased Infra-abdominal Pressure Decreased Increased Cardiac Output Cardiac rate Central Venous Return Pulmonary capillary wedge pressure Visceral blood flow Peak inspiratory pressure Renal blood flow Central venous pressure Glomerular filteration Intrapleural pressure Systemic vascular resistance Management The diagnosis is made by measuring bladder pressure (through Foley catheter). It represents the intraabdoinal pressure. Abdominal compament syndrome is a surgical emergency and treatment includes rapid decompression of the elevated intraabdominal pressure by opening the abdominal wound and performing a temporary closure of the abdominal wall with mesh or a plastic bag. Permanent closure is done 5 to 7 days later when the condition resolves. IAP pressures less than 15 mm of 1120 do not require decompression.
Intra abdominal pressure > 15 cm H2O
Pneumoperitoneum can produce it.
| Renal blood flow
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