Die Therapie des akuten Abdomens aus intensivmedizinischer Sicht – Intraabdominelle Hypertension und das abdominelle Kompartmentsyndrom

Die vielfältigen Ursachen eines akuten Abdomens münden in vollkommen unterschiedliche Therapieansätze. Da ein umfassender Überblick den vorgesehenen Rahmen dieses Beitrags sprengen würde, haben wir den Fokus vor allem auf die Therapie von intraabdomineller Hypertension und abdominellem Kompartmentsyndrom aus der Sicht des internistischen Intensivmediziners gelegt.

Abstract

In critically ill patients an intra-abdominal hypertension is a common phenomenon. An IAH is defined as an IAP persistent ≥ 12 mmHg, an abdominal compartment syndrome is defined as an IAP persistent ≥ 20 mmHg in combination with new organ failure. The bladder pressure serves as a surrogate parameter for the IAP. The bladder pressure should be measured in a standardized manner. The therapy of IAH should be individualized.

Schlüsselwörter

intraabdominelle Hypertension - abdominelles Kompartmentsyndrom - Blasendruckmessung - Ernährung - Beatmungssteuerung

Key words

intra-abdominal hypertension - abdominal compartment syndrome - nutrition - ventilation - measurement oft he bladder pressure

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