title: [Intraabdominal and thoracic pressure in critically ill patients with suspected intraabdominal hypertension].
abstract: OBJECTIVE
  To study the correlation between intraabdominal and intrathoracic pressure in patients with suspected intraabdominal hypertension.
  
  
  METHODS
  A prospective, observational cohort study.
  
  
  METHODS
  Polyvalent intensive care unit of a University hospital.
  
  
  METHODS
  Twenty-seven medical-surgical patient dependent upon controlled mechanical ventilation due to acute respiratory failure and with several risk factors for intraabdominal hypertension (IAH).
  
  
  METHODS
  Intraabdominal (IAP), esophageal (Peso) and airways pressure were measured under static (st) and dynamic (dyn) conditions. Respiratory system (Crs), lung (Cl) and chest wall compliance (Ccw)were calculated.
  
  
  RESULTS
  In 10 patients IAP > 12 mmHg (IAH, IAPst, 14 ± 2 [12-21] mmHg), while in the rest the pressure proved normal (n = 17; IAPst, 8 ± 2 [3-11] mmHg). Peso st was 11 ± 5 (2-27) and Peso dyn 7 ± 4 (2-24) cmH₂O. Depending on the presence or absence of IAH, Peso st was 9 ± 4 vs 7 ± 3 cmH₂O (p = 0.2) and Peso dyn 6 ± 2 vs 4 ± 3 cmH₂O (p = 0.3), respectively. The correlation between Peso st and dyn with IAPst was 0.5 (p= 0.003) and 0.4 (p = 0.03), respectively. The compliance components were decreased (Crs, 31 ± 8; Cl, 52 ± 22 and Ccw, 105 ± 50 ml/cmH₂O); Ccw was significantly lower in patients with IAH (81 ± 31 vs 118 ± 55 ml/cmH₂O; p = 0.02). The correlation coefficient between IAPst and Ccw was -0.7 (p < 0.001), and -0.5 (p = 0.002) with respect to Crs.
  
  
  CONCLUSIONS
  A stiffer chest wall was observed in patients with IAH. In patients with risk factors for IAH, pressures in these compartments were highly variable.
authors.affiliation: Servicio de Cuidados Críticos y Urgencias, Unidad de Medicina Intensiva, Hospital Médico-Quirúrgico, Complejo Hospitalario de Jaén, Jaén, España. frferron@terra.es
authors.forename: F
authors.initials: F
authors.lastname: Ruiz Ferrón
authors.forename: A
authors.initials: A
authors.lastname: Tejero Pedregosa
authors.forename: M
authors.initials: M
authors.lastname: Ruiz García
authors.forename: A
authors.initials: A
authors.lastname: Ferrezuelo Mata
authors.forename: J
authors.initials: J
authors.lastname: Pérez Valenzuela
authors.forename: R
authors.initials: R
authors.lastname: Quirós Barrera
authors.forename: L
authors.initials: L
authors.lastname: Rucabado Aguilar
mesh_terms: D034841:Abdominal Cavity; D000368:Aged; D016638:Critical Illness; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D011312:Pressure; D011446:Prospective Studies; D013909:Thorax