Table 1.

Medical treatment options to reduce IAP

  1. Improve abdominal wall compliance

    • Sedation and analgesia

    • Neuromuscular blockade

    • Avoid head of bed >30°

  2. Evacuate abdominal fluid collections

    • Paracentesis

    • Percutaneous drainage

  3. Evacuate intraluminal contents

    • Nasogastric decompression

    • Rectal decompression

    • Prokinetic agents

  4. Correct positive fluid balance

    • Avoid excessive fluid resuscitation

    • Diuretics

    • Colloids/hypertonic fluids (in patients with severe burns)

    • Hemodialysis/ultrafiltration

  5. Organ support and reducing capillary leak

    • Maintain APP >60 mmHg with vasopressors

    • Optimize ventilation, alveolar recruitment

    • Antibiotic therapy in septic patients

  • Adapted with permission of WSACS from Cheetham ML: Abdominal compartment syndrome. Curr Opin Crit Care 15: 154–162, 2009.