title: The duration of intra-abdominal hypertension strongly predicts outcomes for the critically ill surgical patients: a prospective observational study.
abstract: BACKGROUND
  Intra-abdominal hypertension (IAH) is associated with morbidity and mortality in critically ill patients. The present study analyzed the clinical significance of IAH in surgical patients with severe sepsis.
  
  
  METHODS
  This was a prospective study carried out in the surgical intensive care unit (SICU). Intra-abdominal pressure (IAP) was measured three times a day via a urinary catheter filled with 25 mL of saline. IAH was defined as an IAP ≥ 12 mmHg, and the peak IAP was recorded as the IAP for the day. Data were analyzed in terms of IAH development and the IAH duration.
  
  
  RESULTS
  Of the 46 patients enrolled in the study, 42 developed IAH while in the SICU. The development of IAH aggravated the clinical outcomes; such as longer SICU stay, requirement of ventilator support, and delayed initiation of enteral feeding (EF). The IAH duration showed a significant correlation with pulmonary, renal, and cardiovascular function, and enteral feeding. The IAH duration was an independent predictor of 60-day mortality (odds ratio: 1.196; p = 0.014).
  
  
  CONCLUSIONS
  The duration of IAH is a more important prognostic factor than the development of IAH; thus every effort should be made to reduce the IAH duration in critically ill patients.
  
  
  BACKGROUND
  NCT01784458.
authors.affiliation: Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, Republic of Korea.
authors.forename: Kyu-Hyouck
authors.initials: KH
authors.lastname: Kyoung
authors.affiliation: Division of Trauma and Surgical Critical Care, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul, Republic of Korea.
authors.forename: Suk-Kyung
authors.initials: SK
authors.lastname: Hong
keywords: Enteral feeding, abdominal perfusion pressure; Intra-abdominal hypertension; Intra-abdominal pressure; Severe sepsis