| 6.) What is the pathophysiology in abdominal compartment syndrome?
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The increased intraabdominal pressure may be due to the presence of blood or edema (more common). Ischemia and reperfusion may result in capillary leak and loss of oncotic pressure producing edema. Intraoperative traction on small bowel may interfere with venous and lymphatic drainage compounding the problem. With intraabdominal pressure >15mm Hg, the diaphragms are pushed up, the functional residual capacity is reduced, airway pressures increase, and hypoxia results. At the same time cardiac output is decreased because of decreased preload and increased afterload. Splanchnic blood flow is reduced due to venous compression. As pressures increase, these consequences become worse. There is then clinical hypoxia and oliguria leading to anuric renal failure. If there is no intervention, multiorgan failure and death ensue.
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