Is the way to man's heart (and lung) through the abdomen?

Robert L Owens,Atul Malhotra,R Scott Harris

doi:10.1186/cc8136

Abstract

Intra-abdominal hypertension is increasingly recognized to be both prevalent and clinically important in medical and surgical intensive care units. Intra-abdominal pressure (IAP) can impact organ function throughout the body, and it can also complicate standard measurements used in intensive care units. The article by Krebs and colleagues reports the effect of IAP on respiratory function, gas exchange and hemodynamic function. Their results show a relatively small effect of modestly elevated IAP on these variables in their patient population. However, their work raises several questions for clinicians and researchers regarding the pathophysiology and management of IAP.

Highlights

Several studies have shown that intra-abdominal hypertension (IAH) has prognostic importance through effects on both intra-abdominal and intrathoracic organ function [3]
In the previous issue of Critical Care, Krebs and colleagues systematically studied the effects of intra-abdominal hypertension (IAH) on cardiopulmonary function [1]
The use of esophageal pressure to estimate pleural pressure has been questioned [8], since elevated values were presumed to be an artifact of cardiac weight

Summary

Introduction

Several studies have shown that IAH has prognostic importance through effects on both intra-abdominal and intrathoracic organ function [3]. In the previous issue of Critical Care, Krebs and colleagues systematically studied the effects of intra-abdominal hypertension (IAH) on cardiopulmonary function [1]. IAH may become an even greater issue in the medical intensive care unit with the obesity pandemic, since body mass index is the best independent predictor of IAP [2].

Results

Conclusion