Correlation between intra-abdominal and intracranial pressure in nontraumatic brain injury.
OBJECTIVE
To examine on the basis of a large number of measurements whether increased IAP is associated with increased ICP and decreased CPP in ventilated patients with nontraumatic brain injury.


METHODS
Observational clinical study in the medical and surgical intensive care unit of a tertiary teaching hospital.


METHODS
We included 11 patients with nontraumatic brain injury who had an ICP and an IAP-monitoring device because of ischemic (n=4), hemorrhagic (n=5), and metabolic (n=2) encephalopathy.


METHODS
IAP was continuously measured in the stomach, and ICP was continuously measured through an intraventricular catheter; 214 consecutive measurements were compared. Because of repeated measurements in the patients we used analysis of covariance to control for the variation in ICP and CPP between patients.


RESULTS
Patients' mean IAP was 3.8-11.8 mmHg, ICP 6.7-15 mmHg, and CPP 70.8-123 mmHg. For ICP the regression coefficient associated with IAP was 0.64+/-0.05 (95% CI 0.56-0.73, partial correlation 0.70) and for CPP -1.36+/-0.3 (95% CI -1.94 to -0.78; partial correlation -0.30).


CONCLUSIONS
Increases in IAP are associated with increases in ICP and decreases in CPP in ventilated patients with nontraumatic brain injury, even at low levels of IAP.
Deeren
Dries H
DH
Department of Internal Medicine, ZiekenhuisNetwerk Antwerpen, Campus Stuivenberg, Lange Beeldekensstraat 267, 2060, Antwerp, Belgium.
Dits
Hilde
H
Malbrain
Manu L N G
ML
D018806:APACHE; D000005:Abdomen; D001930:Brain Injuries / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011312:Pressure; D012121:Respiration, Artificial