Prevalence of intra-abdominal hypertension in critically ill patients: a multicentre epidemiological study.
OBJECTIVE
Although intra-abdominal hypertension (IAH) can cause dysfunction of several organs and raise mortality, little information is available on the incidence and risk factors for IAH in critically ill patients. This study assessed the prevalence of IAH and its risk factors in a mixed population of intensive care patients.


METHODS
A multicentre, prospective 1-day point-prevalence epidemiological study conducted in 13 ICUs of six countries.


METHODS
None.


METHODS
Ninety-seven patients admitted for more than 24 h to one of the ICUs during the 1-day study period.


METHODS
Intra-abdominal pressure (IAP) was measured four times (every 6 h) by the bladder pressure method. Data included the demographics, medical or surgical type of admission, SOFA score, etiological factors such as abdominal surgery, haemoperitoneum, abdominal infection, massive fluid resuscitation, and ileus and predisposing conditions such as hypothermia, acidosis, polytransfusion, coagulopathy, sepsis, liver dysfunction, pneumonia and bacteraemia.


RESULTS
We enrolled 97 patients, mean age 64+/-15 years, 57 (59%) medical and 40 (41%) surgical admission, SOFA score of 6.5+/-4.0. Mean IAP was 9.8+/-4.7 mmHg. The prevalence of IAH (defined as IAP 12 mmHg or more) was 50.5 and 8.2% had abdominal compartment syndrome (defined as IAP 20 mmHg or more). The only risk factor significantly associated with IAH was the body mass index, while massive fluid resuscitation, renal and coagulation impairment were at limit of significance.


CONCLUSIONS
Although we found a quite high prevalence of IAH, no risk factors were reliably associated with IAH; consequently, to get valid information about IAH, IAP needs to be measured.
Malbrain
Manu L N G
ML
Medical Intensive Care Unit, ACZA Campus Stuivenberg, Lange Beeldekensstraat 267, 2060 Antwerp, Belgium. manu.malbrain@ skynet.be
Chiumello
Davide
D
Pelosi
Paolo
P
Wilmer
Alexander
A
Brienza
Nicola
N
Malcangi
Vincenzo
V
Bihari
David
D
Innes
Richard
R
Cohen
Jonathan
J
Singer
Pierre
P
Japiassu
Andre
A
Kurtop
Elizabeth
E
De Keulenaer
Bart L
BL
Daelemans
Ronny
R
Del Turco
Monica
M
Cosimini
P
P
Ranieri
Marco
M
Jacquet
Luc
L
Laterre
Pierre-François
PF
Gattinoni
Luciano
L
D000005:Abdomen; D000368:Aged; D015992:Body Mass Index; D005060:Europe / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D007362:Intensive Care Units; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies