Incidence and clinical importance of intraabdominal hypertension in critically ill intensive care patients

Introduction: Intra-abdominal pressure is defined as " relatively balancedpressure in the abdominal cavity". Increased intra-abdominal pressure might effectother systems, especially cardiovascular, respiratory and renal systems. Intraabdominalhypertension causing organ failure is called abdominal compartment syndrome whichis fatal if left untreated. The aim of this study is to asses the frequency ofintraabdominal hypertension (IAH) in medical intensive care unit and its relationship withother clinical and laboratory parameters and effects on mortality.Patients and Methods: Patients hospitalisied more than 24 hours in ÇukurovaUniversity medical intensive care unit and have more than 2 risk factors for theabdominal hypertension were included in this study The patients' age, gender, comorbiddiseases, Apache II score, Glasgow coma scale, the need for mechanical ventilation,surgical history and survival status were recorded. Values above 12 mm Hg intraabdominalpressure was regarded as pathological. Each patient's daily intra-abdominalpressure, urine output, serum lactate, creatinine, the total daily fluid, central venouspressure were also recorded.Results: Patients with intraabdominal hypertension had higher Apache-IIscore, central venous pressure, fluid balance, lower Glasgow coma scale and urineoutput. Median survival of patients with and without intraabdominal hypertension were10, and 13.1 days respectively. (p<0.05). Apache-II score, presence of intraabdominalhypertension, shock and high lactate level were independent risk factors on mortality.Intraabdominal hypertension increased the risk of mortality by 2 fold.Conclusion: The increase intraabdominal pressure was found to be affecting survival and also was foundto be an independent risk factor on mortality.Keywords: Intra-abdominal hypertension, Abdominal compartment syndrome, mortality, survival