La importancia de la presión intrabdominal en trauma y su relación fisiopatología de los sistemas renal, cardiovascular, pulmonar y el sistema nervioso central: [revisión] / Importance of intra abdominal pressure and its physopathological relationship with the renal, cardiovascular, respiratory and central nervous systems: [review]

RESUMEN

El trauma múltiple nos ofrece la oportunidad única de observar la importancia de relacionar la fisiología de los múltiples sistemas del cuerpo humano. La presión intrabdominal y sus expresiones patológicas son temas de gran controversia e interés actual. La discusión y el manejo de dicho tema son fundamentales en la práctica médica actual. Se describe brevemente la fisiología de la presión intrabdominal y sus relaciones con múltiples sistemas. Además, se discuten sus manifestaciones patológicas, como la hipertensión abdominal y el síndrome de compartimiento abdominal, y sus principales causas.

ABSTRACT

Simple and tremendously important physiological concepts such as intraabdominal pressure are commonly relegated in the actual medical education. This review focuses on the physiological and pathological aspects of intraabdominal pressure and its relationship with the renal, cardiovascular, pulmonary, portosystemic visceral and central nervous systems. Methods of measurement and actual definitions of its pathologic expression (intraabdominal hypertension and abdominal compartment syndrome) are also reviewed. The deadly trauma triad and damage control surgery are concepts intimately related with the abdominal compartment syndrome, its physiology and treatment are described briefly. The review also explores the relationship between intra abdominal pressure and intra cranial pressure, and describes a new treatment strategy for intractable intracranial hypertension after traumatic brain injury based on this relationship.The complexity of polytraumatized patients forces us to study from a universal point of view the physiologic phenomena involved, and to identify and treat the repercussions that these may have in the rest of the body. Trauma sets the perfect stage for a better understanding of the body’s physiology and reminds us of the great complexity that is the human body machinery.