ASSESSMENT OF INTRA-ABDOMINAL HYPERTENSION AND ITS CORRELATION TO ORGAN FAILURE IN PATIENTS ADMITTED TO SURGICAL CRITICAL CARE UNIT

Abstract

Background: Intra-abdominal hypertension (IAH) is the sustained elevation in intra-abdominal pressure (IAP) ≥ 12 mmHg. It has been shown to affect various organs of the body, causing derangement and dysfunction of different organ systems. However the problem remains unappreciated and this study was done to assess the problem of IAH among the ICU patients in our own environment and also to understand the signicance of elevated IAPas a marker of organ dysfunction. Objectives Ÿ To assess prevalence of intra-abdominal hypertension in a surgical critical care unit of a tertiary care hospital Ÿ To correlate intra-abdominal hypertension with organ failure in patients admitted to surgical critical care unit. Methodology: This was an observational prospective study done among 75 patients who were admitted for a minimum period of 3 consecutive days in the surgical critical care unit of JMMC&RI, Thrissur from April 2016 to March 2017. The IAP was measured thrice daily, and SOFAscore daily for 3 consecutive days. The results were analyzed using SPSS software. Results: The prevalence of IAH in patients admitted to surgical critical care unit is 46.7% based on mean IAPand 78.7% based on maximum IAP. The mean IAPand SOFAscore were 11.40 ± 4.37 mmHg and 4.55 ± 2.72 respectively. 34.7 % of patients had organ failure. 51.4% of patients with IAH had organ failure. The mortality was 22.9% in population with IAH. The mean ICU stay and hospital stay in patients with IAH were 6.77 ± 4.98 and 13.37 ± 8.09 days respectively Conclusion:The prevalence of IAH in patients admitted to surgical critical care unit is 46.7%. There is a signicantly higher incidence of organ failure, longer ICU stay and hospital stay in patients with IAH. No signicant association was found between IAH and mortality.