Cause

I

Decreased abdominal wall compliance

II

Increased intraluminal contents

III

Increased abdominal contents

IV

Increased capillary leak /fluid resuscitation

Measures

•Adequate sedation and analgesia

•Remove constrictive dressings, abdominal eschars

•Avoid prone position, head of bed more than 20° Reverse Trendelenburg position

•Neuromuscular blockade

•Nasogastric and/or flatus tube

•Gastrocolic prokinetic agents

Erythromycin (200 mg IV q 8 h), metoclopromide (10 mg IV q 6 h), or neostigmine (1–2 mg IV slow infusion)

•Minimize enteral nutrition

•Enemas

•Colonoscopic decompression

•Stop enteral nutrition

•Percutaneous catheter drainage for fluid (indicated if IAP >20 cmHg), USG or CT guided

•Surgical evacuation

•Avoid excessive fluid resuscitation (use hypertonic fluids, colloids)

•Aim zero to negative fluid balance by day 3

•Diuresis once stable

•Hemodialysis/ultrafiltration