| Abstract: While ACS appears to have to been discovered in the last twenty years a large body of knowledge has exited for nearly two centuries. This paper will review historical development of intra-abdominal hypertension (IAH) and the ACS. It was probably Wendt as early at 1867 in Germany who first described the association between IAH and renal impairment 1. There was a lot of conflicting research in the latter part of the 19th Century, but Haven Emerson’s ‘treatise’ intra-abdominal pressures in 1911 laid the foundation for significant knowledge about IAH in cats. In the early 20th century researchers identified the adverse effects of IAH on renal and respiratory function in animals. Around that time innovative pressure measurement transducers were developed in Europe facilitating research. Direct intra-peritoneum pressure was the most usual technique utilised and Overholt, with his manometer, in 1931 described the pressure volume curve of the abdomen2. These techniques were widely used in the treatment of patients with tuberculosis. The first major human research on IAH was by Bradley and Bradley at Massachusetts Memorial Hospital in 1947 where volunteers had renal flow studies undertaken with increasing intra-abdominal pressure3. Baggett, an anaesthetist from Dublin in 1951 suggested that forcing the abdominal contents back into the abdomen could kill patients. It was in 1989 however that Fietsam, from Michigan, coined the term Abdominal Compartment Syndrome. His report describes patients following aortic aneurism surgery and there response to decompressive surgery.
It has taken us 150 years to rediscovered some of the pioneering work of our 19th and 20 th century investigators. IAH and ACS has come full circle!
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