The influence of fluid balance on intra-abdominal pressure after major abdominal surgery.
OBJECTIVE
The objectives of this study were to determine the incidence of intra-abdominal hypertension in patients after major abdominal surgery and to evaluate the correlation of intra-abdominal pressure with fluid balance and systemic inflammatory response syndrome.


METHODS
This is a prospective observational study. Patients, admitted to intensive care unit after major abdominal surgery, were included into the study. Intra-abdominal pressure was measured via a urinary bladder catheter twice daily. Twenty-four-hour fluid balance and systemic inflammatory response syndrome criteria met by the patients were collected daily.


RESULTS
Seventy-seven patients were included into the study. Intra-abdominal hypertension was diagnosed in about 40% of the patients in the early postoperative period. The study showed a significant positive correlation between 24-hour fluid balance and daily changes in intra-abdominal pressure. A significant association was also seen between the number of positive systemic inflammatory response syndrome criteria and intra-abdominal pressure, and intra-abdominal pressure was significantly higher in patients with systemic inflammatory response syndrome. Besides, patients with intra-abdominal hypertension on the first postoperative day had longer length of stay in the intensive care unit.


CONCLUSIONS
Intra-abdominal hypertension occurs commonly in patients after major abdominal surgery, and patients with positive 24-hour fluid balance and/or systemic inflammatory response syndrome are at risk of having higher intra-abdominal hypertension.
Serpytis
Mindaugas
M
Clinic of Anesthesiology and Intensive Care, Vilnius University, Siltnamiu 29, 04130 Vilnius, Lithuania. mindaugas.serpytis@santa.lt
Ivaskevicius
Juozas
J
D018806:APACHE; D000005:Abdomen / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003161:Compartment Syndromes / Q000503:physiopathology; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D006874:Hydrostatic Pressure; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D012307:Risk Factors; D018746:Systemic Inflammatory Response Syndrome; D013997:Time Factors; D014882:Water-Electrolyte Balance