🩺 Intra-abdominal Hypertension & Abdominal Compartment Syndrome (IAH/ACS)
Intra-abdominal hypertension grading and abdominal compartment syndrome (ACS) determination per WSACS, with abdominal perfusion pressure.
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).
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
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
- Kirkpatrick AW, et al. WSACS consensus definitions and guidelines. Intensive Care Med 2013.
- WSACS — The Abdominal Compartment Society resources.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Intra-abdominal pressure IAP (bladder manometry, supine, end-expiration) | 18 mmHg |
|---|---|
| Mean arterial pressure MAP (for APP, optional) | 75 mmHg |
| New-onset organ dysfunction/failure | No |
→IAH gradeIAH grade II (16–20)
- Grade：IAH grade II (16–20)
- Abdominal perfusion pressure APP：APP = MAP − IAP = 75 − 18 = 57 mmHg (target ≥ 60; not met)
- Management direction：IAH: monitor IAP every 4–8 h; medical lowering of abdominal pressure (gastric decompression, drainage, improving abdominal-wall compliance, limiting over-resuscitation, optimizing APP), dynamically reassess organ function
Frequently asked questions
- What is Intra-abdominal Hypertension & Abdominal Compartment Syndrome (IAH/ACS)?
- Intra-abdominal hypertension grading and abdominal compartment syndrome (ACS) determination per WSACS, with abdominal perfusion pressure.
- How is Intra-abdominal Hypertension & Abdominal Compartment Syndrome (IAH/ACS) calculated? What is the core formula?
- 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.
- When is Intra-abdominal Hypertension & Abdominal Compartment Syndrome (IAH/ACS) used?
- Use to grade measured intra-abdominal pressure, identify ACS, and compute abdominal perfusion pressure to guide medical vs surgical management.
- What are the key clinical points for Intra-abdominal Hypertension & Abdominal Compartment Syndrome (IAH/ACS)?
- 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.
- What are the limits and cautions when using Intra-abdominal Hypertension & Abdominal Compartment Syndrome (IAH/ACS)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Intra-abdominal Hypertension & Abdominal Compartment Syndrome (IAH/ACS) calculated in practice? Can you show a worked example?
- Inputs: Intra-abdominal pressure IAP (bladder manometry, supine, end-expiration) 18 mmHg, Mean arterial pressure MAP (for APP, optional) 75 mmHg, New-onset organ dysfunction/failure No → Result: IAH grade IAH grade II (16–20)（Grade: IAH grade II (16–20), Abdominal perfusion pressure APP: APP = MAP − IAP = 75 − 18 = 57 mmHg (target ≥ 60; not met), Management direction: IAH: monitor IAP every 4–8 h; medical lowering of abdominal pressure (gastric decompression, drainage, improving abdominal-wall compliance, limiting over-resuscitation, optimizing APP), dynamically reassess organ function）