ABSTRACT
In animal studies, increases in intra-abdominal pressure (LAP) raise central venous pressure (CVP) and pleural pressure (PP) and, eventually, result in elevation of intracranial pressure (ICP) and decrease of cerebral perfusion pressure (CPP). Clinical studies documented similar correlations. Particularly, in patients with an intracranial hypertension (HICP), in which the compensatory capacities of accepting intracranial volumes are exhausted, the effect of high LAP may induce a further harmful increase in ICP
In head trauma victims with associated intra-abdominal lesions accurate monitoring of LAP is recommended, particularly if HICP is recorded. The cornerstone for treating intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) is the identification of patients at risk and the early recognition and treatment of its harmful effects. Thus, decom pressive laparotomy can be a useful adjunct in the treatment of refractory HICP, after the exclusion of other removable causes, while the use of laparoscopy should be considered an absolute contraindication in HICP patients and should be avoided in patients with recent head injury.
