Intensive Care Medicine

, Volume 30, Issue 5, pp 822–829

Prevalence of intra-abdominal hypertension in critically ill patients: a multicentre epidemiological study

Authors

    • Medical Intensive Care UnitACZA Campus Stuivenberg
  • Davide Chiumello
    • Intensive care Unit, Istituto di Anestesia e RianimazioneOspedale Maggiore Policlinico
  • Paolo Pelosi
    • Intensive Care unitOspedale di Circolo
  • Alexander Wilmer
    • Medical Intensive Care Unit, Division of Internal MedicineUniversity Hospital Gasthuisberg
  • Nicola Brienza
    • Intensive Care Unit, Department of Emergency and Organ TransplantationUniversity of Bari
  • Vincenzo Malcangi
    • Intensive Care Unit, Department of Emergency and Organ TransplantationUniversity of Bari
  • David Bihari
    • Intensive Care UnitThe Prince of Wales Hospital
  • Richard Innes
    • Intensive Care UnitThe Prince of Wales Hospital
  • Jonathan Cohen
    • General Intensive Care UnitRabin Medical Centre
  • Pierre Singer
    • General Intensive Care UnitRabin Medical Centre
  • Andre Japiassu
    • Intensive Care UnitHospital Universitario Clementino Fraga Filho, Federal University of Rio de Janeiro
  • Elizabeth Kurtop
    • Intensive Care UnitThe Prince of Wales Hospital
  • Bart L. De Keulenaer
    • Medical Intensive Care UnitACZA Campus Stuivenberg
  • Ronny Daelemans
    • Medical Intensive Care UnitACZA Campus Stuivenberg
  • Monica Del Turco
    • Department of Surgery, Anesthesia and Intensive Care Section
  • P. Cosimini
    • Department of Surgery, Anesthesia and Intensive Care Section
  • Marco Ranieri
    • Department of Surgery, Anesthesia and Intensive Care Section
  • Luc Jacquet
    • Intensive Care UnitUniversity Hospital St-Luc
  • Pierre-François Laterre
    • Intensive Care UnitUniversity Hospital St-Luc
  • Luciano Gattinoni
    • Intensive care Unit, Istituto di Anestesia e RianimazioneOspedale Maggiore Policlinico
Original

DOI: 10.1007/s00134-004-2169-9

Cite this article as:
Malbrain, M.L.N.G., Chiumello, D., Pelosi, P. et al. Intensive Care Med (2004) 30: 822. doi:10.1007/s00134-004-2169-9

Abstract

Objective

Although intra-abdominal hypertension (IAH) can cause dysfunction of several organs and raise mortality, little information is available on the incidence and risk factors for IAH in critically ill patients. This study assessed the prevalence of IAH and its risk factors in a mixed population of intensive care patients.

Design

A multicentre, prospective 1-day point-prevalence epidemiological study conducted in 13 ICUs of six countries.

Interventions

None.

Patients

Ninety-seven patients admitted for more than 24 h to one of the ICUs during the 1-day study period.

Methods

Intra-abdominal pressure (IAP) was measured four times (every 6 h) by the bladder pressure method. Data included the demographics, medical or surgical type of admission, SOFA score, etiological factors such as abdominal surgery, haemoperitoneum, abdominal infection, massive fluid resuscitation, and ileus and predisposing conditions such as hypothermia, acidosis, polytransfusion, coagulopathy, sepsis, liver dysfunction, pneumonia and bacteraemia.

Results

We enrolled 97 patients, mean age 64±15 years, 57 (59%) medical and 40 (41%) surgical admission, SOFA score of 6.5±4.0. Mean IAP was 9.8±4.7 mmHg. The prevalence of IAH (defined as IAP 12 mmHg or more) was 50.5 and 8.2% had abdominal compartment syndrome (defined as IAP 20 mmHg or more). The only risk factor significantly associated with IAH was the body mass index, while massive fluid resuscitation, renal and coagulation impairment were at limit of significance.

Conclusion

Although we found a quite high prevalence of IAH, no risk factors were reliably associated with IAH; consequently, to get valid information about IAH, IAP needs to be measured.

Keywords

Intra-abdominal pressureIntra-abdominal hypertensionAbdominal compartment syndromeSurgeryTraumaCritically ill patientsIntensive care

Copyright information

© Springer-Verlag 2004