Abdominal compartment syndrome in dogs

Abstract

Budući da je riječ o veoma kompleksnom i nedovoljno istraženom sindromu, razumljivo je kako mu se u znanosti i kliničkoj praksi posljednjih godina pridaje sve više pažnje. Razvoj sindroma abdominalnog odjeljka predstavlja vrlo opasno i hitno stanje sa prilično visokom stopom mortaliteta budući da se uz njega često javljaju i brojne komplikacije kao i multipla organska zatajenja. U humanoj medici ovaj sindrom je prepoznat već godinama te je do sada opisana njegova klasifikacija, etiologija, patofiziologija, klinička slika, dijagnostički postupci u njegovu otkrivanju kao i smjernice liječenja. U veterinarskoj medicini pojava ovog sindroma u kliničkoj praksi veoma često prolazi nedijagnosticirano. Zbog prilično širokog spektra nespecifičnih simptoma koji se kod ovog oboljenja javljaju u pasa, kao i zbog prilično rijetkog prakticiranja mjerenja vrijednosti intraabdominalnog tlaka, razvoj sindroma odjeljka često se ne prepozna ili se kao takav pripisuje drugim organskim bolestima. Iz istog razloga u veterinarskoj medicini obavljeno je premalo pokusa, provedeno je premalo kliničkih ispitivanja ili znanstvenih radova koji bi detaljnije objasnili mehanizam razvoja i progresiju ovog sindroma. Pošto u pasa nisu jasno definirane granične vrijednosti intraabdominalnog tlaka, teško je govoriti kada se zapravo javlja abdominalna hipertenzija i hoće li ona rezultirati pojavom sindroma. Zbog navedenog, smjernice liječenja za sada nisu specifične, nije opisan jasan protokol liječenja u pasa, već se on odvija prema predlošku preuzetom iz humane medicine. Stoga, nesumnjivo je kako je potrebno provesti razna znanstvena i klinička istraživanja koja će pridonijeti boljem shvaćanju ovog sindroma. Usvojena nova znanja pridonijet će njegovu lakšem prepoznavanju, dijagnosticiranju i liječenju na dobrobit svih budućih pacijenata.Since abdominal compartment syndrome is a very complex and insufficiently researched syndrome, it is understandable that in recent years more attention has been given to it in the both science and clinical research. The development of abdominal compartment syndrome represents a very urgent and life threatening condition with a high mortality rate because it is often accompanied by numerous complications as well as multiple organ failure. This syndrome has been recognized in human medicine for years and also its classification, etiology, pathophysiology, clinical symptoms, diagnostis procedures and treatment guidelines have been described as well. On the other hand, the appearance of this syndrome in veterinary clinical practice often goes unrecognized and undiagnosed. Because of a wide range of non-specific symptoms that occur in dogs and also due to the rare practice of measuring intra-abdominal pressure, the development of compartment syndrome is often not recognized in veterinarians or it is attributed to some other organic diseases. For the same reason, very few experiments, clinical trials or scientific studies have been conducted to explain the development and progression of this syndrome in veterinary medicine. Since the limits of intra-abdominal pressure are not clearly defined in dogs, it is difficult to say when abdominal hypertension actually occurs and whether it will turn into a life-treatin condition. Furthermore, the guidelines for treatement in veterinary patients are not specific, an individual treatment protocol for dogs is not described so far, so the treatment is carried out according to guidelines taken from human medicine. To sum up, there is no doubt that it is necessary to organise various scientific and clinical studies that will contribute to a better understanding of this syndrome, which will contribute to its easier recognition, better diagnosis and more successful treatment for the benefit of all future patients