ABSTRACT
S ignificant increases in intra-abdominal pressure (IAP) are seen in a wide variety o f conditions commonly encountered in the intensive care unit.1'3 Abdominal compartment syndrome (ACS) describes the combination of increased intra-abdominal pressure and organ dysfunction.4"6 The incidence of intra-abdominal hypertension (LAH) and ACS varies with the case mix studied and the cut-off pressure used to define LAH.7'9 The World Congress on Abdominal Compartment Syndrome (WCACS) 2004, defined ACS as IAP > 20 mm Hg, associated with single or multiple organ system failure, which was not previously present. Some authors report pulmonary dysfunction as the earliest manifestation of ACS.2 This chapter will discuss the pulmonary derangements in ACS and describe evidence-based treatment principles for mechanical ventilation and pulmonary treatment in ACS.
