Abstract
Objective. The objectives of this study were to determine the incidence of intraabdominal hypertension in patients after major abdominal surgery and to evaluate the correlation of intra-abdominal pressure with fluid balance and systemic inflammatory response syndrome. Material and methods. This is a prospective observational study. Patients, admitted to intensive care unit after major abdominal surgery, were included into the study. Intra-abdominal pressure was measured via a urinary bladder catheter twice daily. Twenty-four-hour fluid balance and systemic inflammatory response syndrome criteria met by the patients were collected daily. Results. Seventy-seven patients were included into the study. Intra-abdominal hypertension was diagnosed in about 40% of the patients in the early postoperative period. The study showed a significant positive correlation between 24-hour fluid balance and daily changes in intraabdominal pressure. A significant association was also seen between the number of positive systemic inflammatory response syndrome criteria and intra-abdominal pressure, and intraabdominal pressure was significantly higher in patients with systemic inflammatory response syndrome. Besides, patients with intra-abdominal hypertension on the first postoperative day had longer length of stay in the intensive care unit. Conclusions. Intra-abdominal hypertension occurs commonly in patients after major abdominal surgery, and patients with positive 24-hour fluid balance and/or systemic inflammatory response syndrome are at risk of having higher intra-abdominal hypertensio
Highlights
There is growing evidence that intra-abdominal pressure (IAP) adversely affects almost all organ systems [1] and is a cause of significant morbidity and mortality [2,3,4,5]
A significant association was seen between the number of positive systemic inflammatory response syndrome criteria and intra-abdominal pressure, and intraabdominal pressure was significantly higher in patients with systemic inflammatory response syndrome
Intra-abdominal hypertension occurs commonly in patients after major abdominal surgery, and patients with positive 24-hour fluid balance and/or systemic inflammatory response syndrome are at risk of having higher intra-abdominal hypertension
Summary
There is growing evidence that intra-abdominal pressure (IAP) adversely affects almost all organ systems [1] and is a cause of significant morbidity and mortality [2,3,4,5]. Many risk factors for the development of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have been identified in critically ill patients [6]. Liberal ( defined as standard or aggressive) strategy has been widely accepted in clinical practice due to beneficial effects on cardiovascular function and tissue perfusion [10, 11]. Administration of large amounts of fluid may cause tissue edema. Increased capillary permeability due to systemic inflammatory response syndrome (SIRS), induced by the surgical trauma, contributes to the distribution of fluid and the development of visceral edema and IAH
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