Excessive fluid resuscitation, particularly with crystalloids, increases the likelihood that multisystem complications occur. Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are lethal complications of excessive fluid resuscitation. Positive fluid balance has shown to increase complications and mortality specifically associated with ACS.

It is recommended that a positive fluid balance be avoided in patients at risk for developing IAH/ACS. The effects of intra-abdominal hypertension are not limited just to the intra-abdominal organs, but rather have an impact either directly or indirectly on every organ system in the body. The mortality associated with ACS has been reported as high as 80%. APP of 60 mm Hg in patients with ACS was 98% sensitive in predicting survival in a population largely composed of trauma patients.

Link: https://pubmed.ncbi.nlm.nih.gov/28478881/