Abstract
IntroductionIntra-abdominal hypertension (IAH) is associated with morbidity and mortality in critically ill patients. The present study analyzed the clinical significance of IAH in surgical patients with severe sepsis.MethodsThis was a prospective study carried out in the surgical intensive care unit (SICU). Intra-abdominal pressure (IAP) was measured three times a day via a urinary catheter filled with 25 mL of saline. IAH was defined as an IAP ≥ 12 mmHg, and the peak IAP was recorded as the IAP for the day. Data were analyzed in terms of IAH development and the IAH duration.ResultsOf the 46 patients enrolled in the study, 42 developed IAH while in the SICU. The development of IAH aggravated the clinical outcomes; such as longer SICU stay, requirement of ventilator support, and delayed initiation of enteral feeding (EF). The IAH duration showed a significant correlation with pulmonary, renal, and cardiovascular function, and enteral feeding. The IAH duration was an independent predictor of 60-day mortality (odds ratio: 1.196; p = 0.014).ConclusionsThe duration of IAH is a more important prognostic factor than the development of IAH; thus every effort should be made to reduce the IAH duration in critically ill patients.Trial registrationNCT01784458
Highlights
Intra-abdominal hypertension (IAH) is associated with morbidity and mortality in critically ill patients
Intra-abdominal pressure (IAP) is defined as the steady-state pressure within the abdominal cavity bounded by the abdominal muscles and diaphragm [1]
The World Society of the Abdominal Compartment Syndrome (WSACS) has published a grading system for intra-abdominal hypertension (IAH), with IAH defined as an IAP ≥12 mmHg, and abdominal compartment
Summary
Intra-abdominal hypertension (IAH) is associated with morbidity and mortality in critically ill patients. The present study analyzed the clinical significance of IAH in surgical patients with severe sepsis. Intra-abdominal pressure (IAP) is defined as the steady-state pressure within the abdominal cavity bounded by the abdominal muscles and diaphragm [1]. It is affected by body weight, posture, tension of abdominal muscles, and movement of the diaphragm [2,3,4]. The aim of the present study was to investigate the influence of IAH development and its duration on the clinical course and outcome of critically ill surgical patients with severe sepsis
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