Clinical relevance of intra-abdominal hypertension in patients with severe acute pancreatitis.
OBJECTIVE
Intra-abdominal hypertension (IAH) contributes to organ failure in patients with abdominal trauma and sepsis and leads to the development of abdominal compartment syndrome (ACS). This study aims to investigate the clinical significance of IAH in patients with severe acute pancreatitis (SAP).


METHODS
Patients admitted to intensive care with SAP underwent daily measurement of intra-abdominal pressure (IAP), recording of the clinical data, and calculation of 4 organ dysfunction scores.


RESULTS
Among 18 patients with SAP, 11 (61%) developed IAH (median, 20 mm Hg), whereas 10 (56%) developed ACS. The IAP correlated significantly with the 4 organ dysfunction scores; the scores were significantly higher when IAH existed than when it did not. The admission IAP correlated significantly with the duration of intensive care stay. Patients who developed IAH/ACS had significantly higher organ failure score and greater mortality compared with those who did not. Laparotomy and drainage reduced the IAP by a median of -11 mm Hg and relieved the IAH/ACS in all patients.


CONCLUSIONS
Intra-abdominal hypertension and ACS are frequent findings in patients with SAP and are associated with deterioration in organ function. Intra-abdominal pressure correlates with the severity of organ failure, and a high admission IAP is associated with prolonged intensive care stay.
Al-Bahrani
Ahmed Z
AZ
Department of Surgery, Hemel Hempstead Hospital, Hemel Hempstead, UK.
Abid
Ghalib H
GH
Holt
Adrian
A
McCloy
Rory F
RF
Benson
Jonathan
J
Eddleston
Jane
J
Ammori
Basil J
BJ
D000005:Abdomen; D000208:Acute Disease; D000328:Adult; D000368:Aged; D003422:Critical Care; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000150:complications; D010195:Pancreatitis / Q000150:complications* / Q000401:mortality / Q000601:surgery