INTRA-ABDOMINAL HYPERTENSION(IAH) ASSESSMENT ALGORITHM (GIF)
Patients should be screened for IAH/ACS risk factors upon ICU admission and with new or progressive organ failure.
If two or more risk factors are present, a baseline IAP measurement should be obtained.
If IAH is present, serial IAP measurements should be performed throughout the patient’s critical illness.
Pacientes con dos o más factoresde riesgo de IAH / ACS o presencia al ingreso en UCI de un nuevo oprogresivo fallo orgánico
Medirla IAP basal
IAP >=12 mmHg? >NO >Reevaluar
SI
Initiate treatment to reduce IAP
Avoid excessive fluidresuscitation
Optimize organ perfusion
IAP >20 with new organ failure?
>>NO >Reevaluar/4h
SI
Patient has ACS
Identificar y tratar causa/etiologiadesencadenante
PrimaryACS? o Secondary or RecurrentACS Is IAP > 25 withprogressive organ failure]
SI
A: Perform / revise abdominal decompression with temporary abdominal closure asneeded to reduce IAP
Is IAP < 25 with progressiveorgan failure
SI
Continue medical treatment optionsto reduce IAP
Medir IAP/APP cada 4 hours
Realizar resucitación equilibrada tanto de la precarga,contractibiliad y postcarga usando coloides, cristaloides o drogas vasoactivas
AVOID EXCESSIVE FLUID RESUSCITATION
APP > 60 mmHg? *
SI
IAP < 12 mmHg consistently?**
SI
IAH has resolved Decreasefrequency of IAP measurements and observepatient for deterioration
*Si APP < 60 mmHg Volver a A (revisar la descompresiónabdominal)
**Si IAP > 12 mmHg continuar con medidas para reducir la IAP
Adapted from Intensive Care Medicine 2006;32(11):1722-1732 & 2007;33(6):951-962
World Society of the Abdominal Compartment Syndrome (WSACS)
Website: http://www.wsacs.org