Abdominal compartment syndrome (ACS) is a critical condition characterized by increased intra-abdominal pressure (IAP), leading to potential organ dysfunction and high mortality if not managed appropriately. It is essential to distinguish between intra-abdominal hypertension (IAH) and ACS: IAH refers to a sustained or repeated pathological elevation of IAP ≥ 12 mm Hg, while ACS involves a sustained IAP > 20 mm Hg with associated new organ dysfunction or failure. The concept of abdominal perfusion pressure (APP), defined as mean arterial pressure (MAP) minus IAP, serves as a crucial marker of abdominal organ perfusion. Maintaining adequate APP is vital to ensure sufficient blood flow to the abdominal organs [1, 2] [Ref: Algorithm 44.1].