A full text review on ventilation in intra-abdominal hypertension.
Intra-abdominal hypertension (IAH) is defined as a sustained increase in intra-abdominal pressure (IAP) equal to or above 12 mmHg. IAH affects the brain, the cardiovascular system and the lungs.
The average incidence of IAH in critically ill patients is around 25–30% on admission, and the cumulative incidence is around 50% during the first week of ICU stay. There is an association between IAH and respiratory failure.
IAH is associated with a decrease in lung volumes, a decrease in chest wall compliance, and abdomino-thoracic pressure transmission, while decompressive laparotomy results in an improvement in lung volumes.
The presence of IAH affects lymphatic drainage between the thoracic and abdominal cavity and may play an important role in the development of edema formation.
The article discusses recruitment maneuvers, PEEP, protective lung ventilation, prone positioning, hemodynamic changes, and the Abdominal Compartment Society guidelines for managing IAH or abdominal compartment syndrome.