SAN ANTONIO, Tex.–The oncology nurse plays a pivotal role in the management of abdominal compartment syndrome (ACS) by focusing on risk assessment and early identification of clinical signs and symptoms, according to a presentation at the ONS 41st Annual Congress.1

“The World Society of Abdominal Compartment Syndrome defines ACS as intra-abdominal pressure that exceeds 20 mmHg accompanied by a related organ failure despite resuscitation and improves following decompression,” said Karshook Wu, BSN, RN, OCN. “ACS can be classified as primary, secondary, or recurrent.”

Although compartment syndrome is rare, it is a significant medical emergency that occurs when pressure within a limited space is increased. ACS is a potentially deadly condition that is caused by any event that produces intra-abdominal hypertension, thereby causing hypoperfusion, ischemia of the intestines, and multiple organ dysfunction.

“ACS is characterized by tense distended abdomen; raised intra-abdominal pressure; increased peak airway pressure; inadequate ventilation with low PO2 and high PCOs; and [unstable] cardiovascular, pulmonary, gastrointestinal, renal, [and/or] central nervous systems,” Wu explained.

Because the symptoms of ACS can mimic other abdominal conditions, making it challenging to formulate a clinical diagnosis, it is important that oncology nurses diligently evaluate for early symptoms of ACS.

Symptoms may include malaise, lightheadedness, dyspnea, abdominal bloating and/or bloating, and peripheral edema. Physical signs consist of a tense distended abdomen, oliguria, acute pulmonary decompensation, metabolic acidosis, jugular vein distension, hypotension, tachycardia, and hypothermia.

REFERENCE

1. Wu K, Davis M, Gonzalez-Diaz J, Ramrup R. Abdominal compartment syndrome: rediscovering an old syndrome to prevent further mortality. Oral presentation at: 2016 Oncology Nursing Society Annual Congress; April 28-May 1, 2016; San Antonio, TX.