Intra-abdominal hypertension and abdominal compartment syndrome - making progress?

摘要

In this issue, Kim et al provide us with prospective, observational data documenting the incidence, associated risk factors and outcome of intra-abdominal hypertension (IAH) in critically ill patients. As with many pathological conditions, once intra-abdominal pressure (IAP) is raised, there is a continuum of severity of IAH, from mild to severe. There are very different treatment and prognostic consequences, dependent on the severity of IAH, and therefore clearly defining where individuals fall within this continuum is important. The World Society of Abdominal Compartment Syndrome (WSACS) definitions provide for such a grading of severity. Like other consensus definitions, the WSACS definitions are not perfect for use in the clinical context, but have the advantage of allowing proper comparison of epidemiological studies, and should facilitate more consistent characterisation of participants in clinical trials when they are used. Kim et al's data are particularly informative because they utilise recent consensus definitions and meticulous measurement technique, in accordance with the definitions and standards agreed by the WSACS.