Skip to main content

Advertisement

SpringerLink
Log in

Prospective Study of Intra-Abdominal Pressure Following Major Elective Abdominal Surgery

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Studies in emergency surgical patients have shown that raised intra-abdominal pressure may adversely affect organ function. The major aim of the present study was to establish the incidence of intra-abdominal hypertension (IAH) in patients undergoing major elective abdominal surgery. A secondary aim was to determine if the development of IAH was associated with poorer outcome.

Methods

Patients undergoing major elective general surgical procedures were recruited to a prospective study in which intra-abdominal pressure was measured for 72 h postoperatively. Outcome data were collected on all patients.

Results

A total of 42 patients with a median age of 63.5 years were studied. Five patients (12%) developed IAH, but this did not lead to a significant increase in the incidence of major organ dysfunction. There was no significant difference in the median length of hospital stay. However the development of IAH was associated with delayed return to oral diet (p < 0.05).

Conclusions

Intra-abdominal hyhpertension occurs in 12% of patients following major elective abdominal surgery and leads to a significantly delayed return to oral diet, but not to an increased length of hospital stay or increased incidence of major organ dysfunction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. De Backer D (1999) Abdominal compartment syndrome. Crit Care 3:R103–R104

    Article  Google Scholar 

  2. Emerson H (1911) Intra-abdominal pressures. Arch Intern Med 7:754–784

    Google Scholar 

  3. Bradley S, Bradley G (1947) The effect of increased abdominal pressure on renal function. J Clin Invest 26:1010–1015

    Article  PubMed  CAS  Google Scholar 

  4. Coombs H (1920) The mechanism of regulation of intra-abdominal pressure. Am J Physiol 61:159–163

    Google Scholar 

  5. Wendt E (1876) Ueber den Einfluss des intraabdominalen Druckes auf die Absonderungsgeschwindigkeit des Harnes. Arch Physiol Heilk 57:527

    Google Scholar 

  6. Baggot MG (1951) Abdominal blow-out: a concept. Curr Res Anesth Analg 30:295–299

    PubMed  CAS  Google Scholar 

  7. Hunter JD, Damani Z (2004) Intra-abdominal hypertension and the abdominal compartment syndrome. Anaesthesia 59:899–907

    Article  PubMed  CAS  Google Scholar 

  8. Barnes GE, Laine GA, Giam PY et al (1985) Cardiovascular responses to elevation of intra-abdominal hydrostatic pressure. Am J Physiol 248(2 Pt 2):R208–R213

    PubMed  CAS  Google Scholar 

  9. Ridings PC, Bloomfield GL, Blocher CR et al (1995) Cardiopulmonary effects of raised intra-abdominal pressure before and after intravascular volume expansion. J Trauma 39:1071–1075

    Article  PubMed  CAS  Google Scholar 

  10. Bailey J, Shapiro MJ (2000) Abdominal compartment syndrome. Crit Care 4:23–29

    Article  PubMed  CAS  Google Scholar 

  11. Doty JM, Saggi BH, Sugerman HJ et al (1999) Effect of increased renal venous pressure on renal function. J Trauma 47:1000–1003

    Article  PubMed  CAS  Google Scholar 

  12. Caldwell CB, Ricotta JJ (1987) Changes in visceral blood flow with elevated intraabdominal pressure. J Surg Res 43:14–20

    Article  PubMed  CAS  Google Scholar 

  13. Diebel LN, Dulchavsky SA, Wilson RF (1992) Effect of increased intra-abdominal pressure on mesenteric arterial and intestinal mucosal blood flow. J Trauma 33:45–48 (discussion 48–49)

    PubMed  CAS  Google Scholar 

  14. Diebel LN, Wilson RF, Dulchavsky SA et al (1992) Effect of increased intra-abdominal pressure on hepatic arterial, portal venous, and hepatic microcirculatory blood flow. J Trauma 33:279–282 (discussion 282–273)

    Article  PubMed  CAS  Google Scholar 

  15. Malbrain ML, Chiumello D, Pelosi P et al (2004) Prevalence of intra-abdominal hypertension in critically ill patients: a multicentre epidemiological study. Intensive Care Med 30:822–829

    Article  PubMed  Google Scholar 

  16. Lonardo M, Piazza O (2005) Incidence of intraabdominal hypertension in the intensive care unit. Crit Care Med 33:2150 (reply 2150–2153)

    Article  PubMed  Google Scholar 

  17. Malbrain ML, Chiumello D, Pelosi P et al (2005) Incidence and prognosis of intraabdominal hypertension in a mixed population of critically ill patients: a multiple-center epidemiological study. Crit Care Med 33:315–322

    Article  PubMed  Google Scholar 

  18. Biancofiore G, Bindi M, Boldrini A et al (2004) Intraabdominal pressure in liver transplant recipients: incidence and clinical significance. Transplant Proc 36:547–549

    Article  PubMed  CAS  Google Scholar 

  19. Sugrue M, Jones F, Deane SA et al (1999) Intra-abdominal hypertension is an independent cause of postoperative renal impairment. Arch Surg 134:1082–1085

    Article  PubMed  CAS  Google Scholar 

  20. Sugrue M (2005) Abdominal compartment syndrome. Curr Opin Crit Care 11:333–338

    Article  PubMed  Google Scholar 

  21. De Potter TJ, Dits H, Malbrain ML (2005) Intra- and interobserver variability during in vitro validation of two novel methods for intra-abdominal pressure monitoring. Intensive Care Med 31:747–751

    Article  PubMed  Google Scholar 

  22. Bennett-Guerrero E, Welsby I, Dunn TJ et al (1999) The use of a postoperative morbidity survey to evaluate patients with prolonged hospitalization after routine, moderate-risk, elective surgery. Anesth Analg 89:514–519

    Article  PubMed  CAS  Google Scholar 

  23. Malbrain ML, Deeren D, De Potter TJ (2005) Intra-abdominal hypertension in the critically ill: it is time to pay attention. Curr Opin Crit Care 11:156–171

    Article  PubMed  Google Scholar 

  24. Papavassiliou V, Anderton M, Loftus IM et al (2003) The physiological effects of elevated intra-abdominal pressure following aneurysm repair. Eur J Vasc Endovasc Surg 26:293–298

    Article  PubMed  CAS  Google Scholar 

  25. Sugrue M, Buist MD, Hourihan F et al (1995) Prospective study of intra-abdominal hypertension and renal function after laparotomy. Br J Surg 82:235–238

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK

    John M. Scollay

  2. Department of Anaesthetics, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK

    Ishrat de Beaux

  3. Department of Clinical and Surgical Sciences (Surgery), University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK

    Rowan W. Parks

Authors
  1. John M. Scollay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ishrat de Beaux
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rowan W. Parks
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John M. Scollay.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Scollay, J.M., de Beaux, I. & Parks, R.W. Prospective Study of Intra-Abdominal Pressure Following Major Elective Abdominal Surgery. World J Surg 33, 2372–2377 (2009). https://doi.org/10.1007/s00268-009-0191-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-009-0191-3

Keywords

Search

Navigation