Intensive Care Medicine

, Volume 30, Issue 5, pp 822–829 | Cite as

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

  • Manu L. N. G. Malbrain
  • Davide Chiumello
  • Paolo Pelosi
  • Alexander Wilmer
  • Nicola Brienza
  • Vincenzo Malcangi
  • David Bihari
  • Richard Innes
  • Jonathan Cohen
  • Pierre Singer
  • Andre Japiassu
  • Elizabeth Kurtop
  • Bart L. De Keulenaer
  • Ronny Daelemans
  • Monica Del Turco
  • P. Cosimini
  • Marco Ranieri
  • Luc Jacquet
  • Pierre-François Laterre
  • Luciano Gattinoni
Original

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 pressure Intra-abdominal hypertension Abdominal compartment syndrome Surgery Trauma Critically ill patients Intensive care 

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Manu L. N. G. Malbrain
    • 1
  • Davide Chiumello
    • 2
  • Paolo Pelosi
    • 3
  • Alexander Wilmer
    • 4
  • Nicola Brienza
    • 5
  • Vincenzo Malcangi
    • 5
  • David Bihari
    • 6
  • Richard Innes
    • 6
  • Jonathan Cohen
    • 7
  • Pierre Singer
    • 7
  • Andre Japiassu
    • 8
  • Elizabeth Kurtop
    • 6
  • Bart L. De Keulenaer
    • 1
  • Ronny Daelemans
    • 1
  • Monica Del Turco
    • 9
  • P. Cosimini
    • 9
  • Marco Ranieri
    • 9
  • Luc Jacquet
    • 10
  • Pierre-François Laterre
    • 10
  • Luciano Gattinoni
    • 2
  1. 1.Medical Intensive Care UnitACZA Campus StuivenbergAntwerpBelgium
  2. 2.Intensive care Unit, Istituto di Anestesia e RianimazioneOspedale Maggiore PoliclinicoMilanItaly
  3. 3.Intensive Care unitOspedale di CircoloVareseItaly
  4. 4.Medical Intensive Care Unit, Division of Internal MedicineUniversity Hospital GasthuisbergLeuvenBelgium
  5. 5.Intensive Care Unit, Department of Emergency and Organ TransplantationUniversity of BariBariItaly
  6. 6.Intensive Care UnitThe Prince of Wales HospitalRandwickAustralia
  7. 7.General Intensive Care UnitRabin Medical CentrePetah TikvaIsrael
  8. 8.Intensive Care UnitHospital Universitario Clementino Fraga Filho, Federal University of Rio de JaneiroRio de JaneiroBrazil
  9. 9.Department of Surgery, Anesthesia and Intensive Care SectionPisaItaly
  10. 10.Intensive Care UnitUniversity Hospital St-LucBrusselsBelgium

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