Intra-abdominal hypertension in the ICU – a prospective epidemiological study

Aim: The present study analyzed the clinical significance of duration of intra-abdominal hypertension (IAH) associated with increased serum lactate in critically ill patients with severe sepsis. Materials and Methods: Our study was an observational, prospective study carried out in the Surgical Intensive Care Unit (ICU) at J.L.N Medical College, Ajmer, Rajasthan, India. In our study, we included a total of 100 patients and intra-abdominal pressure (IAP) was measured through intravesical route at the time of admission and after 6, 12, 24, 48, and 72 h via a urinary catheter filled with 25 ml of saline. Duration of ICU and hospital stay, need for ventilator support, initiation of enteral feeding, serum lactate level at time of admission and after 48 h, and 30-day mortality were noted as outcomes. Results: In our study, an overall incidence of IAH was 60%. Patients with cardiovascular surgery and renal and pulmonary dysfunction were 93.3%, 55%, and 60%, respectively, at the time of admission and 65%, 10%, and 10%, respectively, after 72 h of admission in the surgical ICU. Nonsurvivors had statistically significant higher IAP and serum lactate levels than survivors. Patients with longer duration of IAH had longer ICU and hospital stay, longer duration of vasopressors and ventilator support, and delayed enteral feeding. Conclusion: There is a strong relationship “risk accumulation” between duration of IAH associated with increased serum lactate and organ dysfunction. The duration of IAH was an independent predictor of 30-day mortality. Early recognition and prompt intervention for IAH and severe sepsis are essential to improve the patient outcomes.

show abstract

“…In the elective surgery group, there was 12.5% IAH, while in the emergency group, IAH was 43.75%, and in the medical patients, it was 42.5%. [10]…”

Section: Discussionmentioning

confidence: 99%

The duration of intra-abdominal hypertension and increased serum lactate level are important prognostic markers in critically ill surgical patient's outcome: A prospective, observational study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Simonson et al (8) reported that higher survival rates may be possible with early interventions via education of health professionals in related departments about measuring and evaluation of IAP. Arabadzhiev et al (9) reported in their study with ICU patients that early decompression decreases mortality rates. Therefore, routine IAP evaluation in ICU population can reduce both mortality rates and length of hospital stay.…”

Section: Resultsmentioning

confidence: 98%

The Ultrasonographic Evaluation of Vena Cava Inferior Diameter as an Intraabdominal Pressure Indicator

Ertaş

Buldanlı²,

Girisgin

et al. 2020

Düzce Tıp Fakültesi Dergisi

View full text Add to dashboard Cite

Aim: Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are accepted as a significant cause of morbidity and mortality. The aim of this study is to investigate the utility of ultrasonography (US) as a non-invasive technique for evaluation of IAH, ACS and abdominal perfusion pressure (APP). Material and Methods: Ninety-five patients with intensive care unit requirement, who applied to emergency department and also received a urine catheter were included in the study. During first evaluation intraabdominal pressure (IAP) calculated via measuring intravesical pressure. Inferior vena cava (VCI) diameter, pulsed wave (PW) and central venous pressure (CVP) were recorded by using US. Patients were divided into three groups according to their IAP (IAP 20 mm Hg). Each group were evaluated separately in terms of VCI inspirium (i) and expirium (e) diameters. Results: Mean age of the patients was 68.6±14.5 (range, 24-91) years. Median IAP was 9.55 mm Hg and mean APP was 70.41±17.67 mm Hg. VCIi and VCIe diameters were significantly different in Group 1 with normal (

show abstract

“…Dalfino et al [28] studied 123 patients with ICU hospitalization longer than 24 hours and observed that IAH was associated with age, accumulated fluid balance, shock, sepsis, and abdominal surgery, but only the first three were found to be independent risk factors. Another multicenter study, which analyzed 358 patients from 39 ICUs who included patients requiring mechanical ventilation for more than 6 hours, showed that 22% of patients without additional risk factors had IAH [39].…”

Section: Discussionmentioning

confidence: 99%

Clinical warning signs for intra-abdominal hypertension in septic shock patients

Dorigatti

Pereira

Melek

et al. 2019

ait

View full text Add to dashboard Cite

Abdominal compartment syndrome (ACS) is defined as a sustained intra-abdominal pressure > 20 mm Hg (> 3 kPa), with or without an abdominal perfusion pressure < 60 mm Hg (< 8 kPa), that is associated with new organ dysfunction or failure [1]. It leads to decreased organ perfusion, tissue ischemia, organ failure and death if not identified and adequately treated [2].Although the effects of elevated intra-abdominal pressure have been known since the late 19 th century [3], it was not until the early 1980s that the term ACS was first used by Kron et al. to describe the pathophysiology of intra-abdominal hypertension (IAH) secondary to aortic aneurysm surgery [4,5].

show abstract

Intra-abdominal hypertension in the ICU – a prospective epidemiological study

Cited by 8 publications

References 19 publications

The duration of intra-abdominal hypertension and increased serum lactate level are important prognostic markers in critically ill surgical patient's outcome: A prospective, observational study

The duration of intra-abdominal hypertension and increased serum lactate level are important prognostic markers in critically ill surgical patient's outcome: A prospective, observational study

The Ultrasonographic Evaluation of Vena Cava Inferior Diameter as an Intraabdominal Pressure Indicator

Clinical warning signs for intra-abdominal hypertension in septic shock patients

Contact Info

Product

Resources

About