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🩺 Intra-abdominal Hypertension & Abdominal Compartment Syndrome (IAH/ACS)

Intra-abdominal hypertension grading and abdominal compartment syndrome (ACS) determination per WSACS, with abdominal perfusion pressure.

Intra-abdominal Hypertension & Abdominal Compartment Syndrome (IAH/ACS)

Intra-abdominal pressure IAP (bladder manometry, supine, end-expiration) (mmHg)
Mean arterial pressure MAP (for APP, optional) (mmHg)
New-onset organ dysfunction/failure

When to use

Use to grade measured intra-abdominal pressure, identify ACS, and compute abdominal perfusion pressure to guide medical vs surgical management.

How it works

IAH = sustained IAP ≥ 12 mmHg, graded I (12–15) / II (16–20) / III (21–25) / IV (> 25); ACS = sustained IAP > 20 with new-onset organ dysfunction. APP = MAP − IAP, target ≥ 60 mmHg.

Key points

  • IAP must be measured correctly (bladder manometry, supine, end-expiration, zeroed at the mid-axillary line) or the grade is meaningless (original synthesis · not guideline verbatim).
  • ACS is defined by organ dysfunction, not by an absolute pressure alone — progression rate and duration matter.
  • Refractory ACS is a surgical emergency requiring decompressive laparotomy after medical measures fail.

References

Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.

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