Intraabdominal pressure monitoring during fluid resuscitation

Abstract

Elevated intraabdominal pressure is commonly encountered in the critically ill, has detrimental effects on all organ systems, and is associated with significant morbidity and mortality. Serial intraabdominal pressure measurements are essential to the diagnosis, management, and fluid resuscitation of patients who develop intraabdominal hypertension and/or abdominal compartment syndrome. Over the past year, the importance of intraabdominal pressure measurements and their accurate determination has been further defined. Several nonoperative therapies have been demonstrated to reduce the morbidity and mortality of intraabdominal hypertension/abdominal compartment syndrome, all of which are guided by measurements of intraabdominal pressure. The World Society of the Abdominal Compartment Syndrome has published evidence-based medicine consensus guidelines for the measurement of intraabdominal pressure and its utilization in the diagnosis and resuscitation of the critically ill. Serial intraabdominal pressure measurements are essential for the diagnosis and management of intraabdominal hypertension/abdominal compartment syndrome. Intraabdominal pressure must be measured accurately and utilized in a goal-directed fashion to guide fluid and end-organ resuscitation. As a result of its ability to predict survival among the critically ill, intraabdominal pressure should be routinely monitored in the patient who demonstrates risk factors for intraabdominal hypertension/abdominal compartment syndrome.