Acute renal failure: Beware development of abdominal compartment syndrome

doi:10.1136/bmj.333.7574.917-c

BMJ 2006;333:917-918 (28 October), doi:10.1136/bmj.333.7574.917-c

Letter

Acute renal failure

Beware development of abdominal compartment syndrome

The first 150 words of the full text of this article appear below.

EDITOR—In her review of acute renal failure Hilton acknowledgesthat the immediate care of most such patients in the UnitedKingdom is provided in intensive care units by intensivistsbut does not sufficiently emphasise the effective clinical approachto resuscitation in intensive care.¹ In particular, adequaterenal perfusion pressure must be maintained in patients whohave a raised intra-abdominal pressure, and this can often preventthe need for renal replacement therapy.

Abdominal compartment syndrome occurs if the intra-abdominalpressure is greater than 20 mm Hg and associated with organdysfunction such as oliguria.² If unrecognised or untreateda persistently raised intra-abdominal pressure can result inacute renal failure. This condition is well recognised by intensivists:three quarters of intensive care units measure intraabdominalpressure through the intravesical route.³ If abdominal compartmentsyndrome develops, acute renal failure can be prevented by continuedfluid resuscitation, use of vasopressors, and decompression. . . [Full text of this article]