Abdominal perfusion pressure: a superior parameter in the assessment of intra-abdominal hypertension.
OBJECTIVE
To assess the clinical utility of abdominal perfusion pressure (mean arterial pressure minus intra-abdominal pressure) as both a resuscitative endpoint and predictor of survival in patients with intra-abdominal hypertension.


METHODS
144 surgical patients treated for intra-abdominal hypertension between May 1997 and June 1999 were retrospectively reviewed. Multivariate logistic regression and receiver operating characteristic curve analysis of common physiologic variables and resuscitation endpoints were performed to determine the decision thresholds for each variable that predict patient survival.


RESULTS
Abdominal perfusion pressure was statistically superior to both mean arterial pressure and intravesicular pressure in predicting patient survival from intra-abdominal hypertension and abdominal compartment syndrome. Multiple regression analysis demonstrated that abdominal perfusion pressure was also superior to other common resuscitation endpoints, including arterial pH, base deficit, arterial lactate, and hourly urinary output.


CONCLUSIONS
Abdominal perfusion pressure appears to be a clinically useful resuscitation endpoint and predictor of patient survival during treatment for intra-abdominal hypertension and abdominal compartment syndrome.
Cheatham
M L
ML
Department of Surgical Education, Orlando Regional Medical Center, Florida 32806, USA. mikec@orhs.org
White
M W
MW
Sagraves
S G
SG
Johnson
J L
JL
Block
E F
EF
D000007:Abdominal Injuries / Q000150:complications* / Q000175:diagnosis; D001794:Blood Pressure; D003161:Compartment Syndromes / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D015999:Multivariate Analysis; D012044:Regression Analysis; D012151:Resuscitation / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013152:Splanchnic Circulation; D015996:Survival Rate