ABSTRACT
C ardiovascular dysfunction and failure are commonly encountered in the patient with intra-abdominal hypertension (IAH) or abdominal compartment syndrome (ACS). Accurate assessment and optimization of preload, contractility, and afterload is essen tial to restoring end-organ perfusion and function in such patients. Our understanding of traditional hemodynamic monitoring techniques and parameters, however, must be reevalu ated in the patient with IAH/ACS as pressure-based estimates of intravascular volume such as pulmonary artery occlusion pressure (PAOP) and central venous pressure (CVP) have known limitations in patients with elevated intra-abdominal pressure (LAP). If such limitations are not recognized, misinterpretation of the patients minute-to-minute cardiac status may result in the institution of inappropriate and potentially detrimental therapy. Volumetric monitoring techniques have been proven to be superior to PAOP and CVP in ensuring appropriate resus citation of the patient with IAH/ACS. Application of an aggressive, goal-directed resuscitation strategy improves cardiac function, reverses end-organ failure, and minimizes LAH-related pa tient morbidity and mortality.
