Intra-abdominal hypertension is not reliable as an early predictor of mortality in the intensive care unit.
OBJECTIVE
The aim of this study was to assess the prevalence of intra-abdominal hypertension and its prognostic value in critical patients.


METHODS
In an observational study, 56 patients of a multidisciplinary intensive care unit (ICU) of a university hospital, with either surgical (44.6%) or medical (55.4%) diagnoses, were studied. Intra-abdominal pressure was quantified daily by bladder pressure method from the first to the eighth day of hospitalization.


RESULTS
The mean intra-abdominal pressure at admission was 9.97+/-5.26 mmHg; 41% of patients suffered moderate intra-abdominal hypertension (defined as intra-abdominal pressure greater than 11 mmHg) at admission. On day 1 mean intra-abdominal pressure was not significantly different between the patients who died and those who survived (9.69+/-5.06 mmHg vs 10.12+/-5.57 mmHg respectively), but by measuring IAP until day 8 it was possible to distinguish a subgroup of patients who showed a persistently elevated intra-abdominal pressure, developed further complications, later died (12.5+/-4.37 mmHg vs 7.17+/-2.02 mmHg, P=0.022).


CONCLUSIONS
Intra-abdominal pressure does not have prognostic value at ICU admission, but may predict bad outcomes later during the ICU stay. Intra-abdominal hypertension is a frequent and rarely recognized event in the ICU which can be monitored by the bladder pressure method throughout the period of hospitalization.
Lonardo
M
M
Department of Surgical Sciences, Anesthesiology and Critical Care, University Federico II, Naples, Italy.
Piazza
O
O
De Marco
G
G
De Robertis
E
E
Servillo
G
G
Tufano
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D001743:Urinary Bladder / Q000502:physiology