Control of Intractable Abdominal Bleeding by External Counterpressure

Pressure of 20 to 25 mm Hg circumferentially applied to the abdomen and legs for periods up to 48 hours is a safe, effective, and practical adjunct to standard medical and surgical techniques for controlling intra-abdominal hemorrhage. Pressure is distributed uniformly through the abdominal cavity and aids hemostasis by decreasing transmural pressure and blood flow in arteries and veins. Compression of the venous capacitance reservoir causes shunting of blood to vital organs above the diaphragm. The mechanism of action, optimal pressures, physiological effects, indications, contraindications, and possible harmful effects of circumferential pneumatic compression are discussed.