Continuous Intra-Abdominal Pressure Measurement: Re-Discovered

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Continuous Intra-Abdominal Pressure Measurement: Re-Discovered

Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 9, Issue 3

Abstract

Last year was the 10th anniversary of the first publication on Polycompartment Syndrome. The term "Multiple Compartment Syndrome" was introduced by Scalea in 2007 suggesting the complex interplay between body compartments [1]. The ’’Polycompartment Syndrome" as a”terminus technicus" was published by Malbrain in the same year [2]. The human body is subdivided into smaller or larger units by well-defined compartments. The function of these compartments is to mechanically protect and separate the organs or organ systems situated inside them. Distinctively separated spaces of our bodies are the different fascial compartments, the skull, the spinal canal, the orbit, the pericardium, the thoracic and the abdominal cavities. The elasticity of the tissues of the separating walls (bone, muscle, connective tissue) have a strong determinative effect on the tolerance for volume or pressure changes exerted on the organs which can be found inside these compartments. Compartment syndrome in a wider sense defines those changes which occur in the given compartments due to the increased pressure (which apart from some lesser and/or greater fluctuations is constant under physiological circumstances) and to the decrease in local circulation developing in consequence of this. Detrimental effects of the increased pressure are widely known and precisely described in the medical literature [3]. Herniation syndromes occurring as a consequence of the increased intracranial pressure, the clinical appearance of pneumothorax and haemothorax caused by pathological accumulation of air or fluids inside the thoracic cavity, as well as the concept of pericardial tamponade are known by everybody and no one questions that all the above cases represent a compartment syndrome occurring as a consequence of the increased pressure having been elevated due to certain specific reasons. Upon mentioning, associations are immediately made to fascial compartments [2], however, the term compartment syndrome means the clinical picture of the entirety of pathophysiological alterations developing in consequence of the increased pressure occurring within a closed space; and this is irrespective whether the separating compartment itself is formed by the skull, the thorax, the abdominal cavity or a given fascial compartment. A common characteristic of these syndromes is the permanent and irreversible damage that may affect the organs which can be found inside the given compartment if quick intervention cannot be provided. If vital organs are affected these damages can be life-threatening or may even lead to death [3]. Abdominal compartment syndrome (ACS) was first described in relation to abdominal traumatic injuries. Kron was the first, who albeit did not use the term itself, yet described compartment syndrome in 1984. It was again Kron who routinely used abdominal pressure measurement through bladder catheterisation, which became widespread by 1989; however, the fundamentals of the method were described 100 years prior by Oderbrecht.

Authors and Affiliations

Zsolt Bodnar

Keywords

EP ID EP591748
DOI 10.26717/BJSTR.2018.09.001795
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