title: Effects of intra-abdominal pressure on liver function assessed with the LiMON in critically ill patients.
abstract: BACKGROUND
  Intra-abdominal pressure (IAP) and intra-abdominal hypertension (IAH) are associated with significant morbidity and mortality in critically ill patients. Our aim was to assess the effects of IAH on liver function using the noninvasive liver function monitoring system LiMON and to assess the prognostic value of IAP in critically ill patients.
  
  
  METHODS
  We conducted a retrospective analysis of critically ill patients who were treated in the intensive care unit (ICU). The IAP and indocyanine green plasma disappearance rate (ICG-PDR) measurements were made within 24 hours after admission to the ICU and repeated 12 hours later. Intra-abdominal pressure was measured via a Foley bladder catheter, and ICG elimination tests were conducted concurrently using the LiMON.
  
  
  RESULTS
  We included 30 critically ill patients (17 women and 13 men aged 28-89 yr) in our analysis. Statistical analysis showed that the baseline IAP values were significantly higher among nonsurvivors than survivors (19.38 [standard deviation; SD 2.08] v. 13.07 [SD 0.99]). The twelfth-hour IAP values were higher than baseline measurements among nonsurvivors (21.50 [SD 1.96]) and lower than baseline measurements among survivors (11.71 [SD 1.54]); the difference between groups was significant (p < 0.001). The baseline ICG-PDR values were significantly lower among nonsurvivors than survivors (10.86 [SD 3.35] v. 24.51 [SD 6.78]), and the twelfth-hour ICGPDR values were decreased in all groups; the difference between groups was significant (p < 0.001).
  
  
  CONCLUSIONS
  Our results suggest that measurement of ICG-PDR with the LiMON is a good predictor of the effects of IAP on liver function and, thus, can be recommended for the evaluation of critically ill patients.
authors: Department of Anesthesiology, Trakya University Medical Faculty, Edirne, Turkey. mehturinal@yahoo.com
authors: Mehmet Turan
authors: MT
authors: Inal
authors: Dilek
authors: D
authors: Memis
authors: Y Atakan
authors: YA
authors: Sezer
authors: Meltem
authors: M
authors: Atalay
authors: Abdullah
authors: A
authors: Karakoc
authors: Necdet
authors: N
authors: Sut
mesh_terms: D034841:Abdominal Cavity / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007362:Intensive Care Units; D008111:Liver Function Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase