Intra-abdominal pressure values of emergency department intensive care unit patients and clinical outcomes

Introduction

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have become serious causes of morbidity and mortality in critical surgical and medical patients, especially in the past 10 years. Increased IAP levels became one of the routine physiologic parameter measurement elements in critical patients and indicate prognosis. In this study, our aim was to observe IAP increase, APB decrease and their clinical manifestations in ICU patients.

Methods

Eighty-nine ICU patients were included in this study. IAP levels were measured by infusing 25 ml saline into the urinary bladder. The symphisis pubis plane affiliated as the zero point. Patients were divided into groups according to IAP and APB levels. Clinical follow-up, required medical care and survival were investigated.

Results

Within the 89 patients, 36 of them diagnosed as IAH and 34 of them diagnosed as low APB. There were 25 patients that had both IAH and low APB. In these patients, during the first 2 days of the study, statistically significant SGOT, SGPT, PO₂, urea and creatinine levels were found. We also determined increased positive inotropic support and ventilatory support need with increased sepsis and multiple organ failure incidence in these patients. Mortality rates were strongly related to IAH and low APB levels.

Conclusions

In critically ill patients, IAP measurement, a very simple and valuable method, must be performed. IAH and low APB levels are indicators of high morbidity and mortality rates. Therefore, IAP measurement may become a routine element in follow-ups and survival rate determinations, in critically ill patients.