Journal of the Chinese Medical Association : JCMA
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Abdominal compartment syndrome (ACS) is defined as intra-abdominal hypertension associated with organ dysfunction. Subsequently, increased intra-abdominal pressure (IAP) adversely affects the pulmonary, cardiovascular, renal, musculoskeletal/integumentary and central nervous systems. Bacterial translocation (BT), which is defined as the movement of viable enteric bacteria to the mesenteric lymph nodes, liver and spleen, occurs after various types of stress and results in splanchnic ischemia. In this experimental study, we aimed to investigate the effects of various levels of increased IAP on BT in rabbits; IAP was increased by the intra-abdominal balloon-insufflation method, thus simulating noncompliant abdominal-wall closure under tension. ⋯ We propose that an intravesical pressure (IVP) of 15 mmHg is the critical point for BT in patients with increased IAP. In this experimental study, BT occurred when IVP reached 20 mmHg. We suggest that IVP monitoring is desirable in the management of patients with ACS, and that decompressive laparotomy should be performed in patients with IVP >20 mmHg.