Format

Send to

Choose Destination
Curr Opin Crit Care. 2004 Apr;10(2):132-45.

Is it wise not to think about intraabdominal hypertension in the ICU?

Author information

1
Medical ICU, ACZA Campus Stuivenberg, Antwerpen, Belgium. manu.malbrain@skynet.be

Abstract

PURPOSE OF REVIEW:

This review focuses on the available literature published in the past 2 years. MEDLINE and PubMed searches were performed using intraabdominal pressure, intraabdominal hypertension, and abdominal compartment as search items. The aim was to find an answer to the question: "Is it wise not to measure or even not to think about intraabdominal hypertension in ICU?"

RECENT FINDINGS:

It is difficult to find a good gold standard for intraabdominal pressure measurement. Bladder pressure can be used as an intraabdominal pressure estimate provided it is measured in a reproducible way. Automated continuous intraabdominal pressure monitoring has recently become available. Key messages are (1). body mass index and fluid resuscitation are independent predictors of intraabdominal hypertension; (2). intraabdominal hypertension increases intrathoracic, intracranial, and intracardiac filling pressures; (3). transmural or transabdominal filling pressures combined with volumetric parameters better reflect preload; (4). volumetric target values need to be corrected for baseline ejection fractions; (5). intraabdominal hypertension decreases left ventricular, chest wall and total respiratory system compliance; (6). best positive end-expiratory pressure can be set to counteract intraabdominal pressure; (7). acute respiratory distress syndrome definitions should take into account best positive end-expiratory pressure and intraabdominal pressure but not wedge pressure; (8). lung protective strategies should aim at deltaPplat (plateau pressure - intraabdominal pressure); (9). intraabdominal hypertension causes atelectasis and increases extravascular lung water; (10). intraabdominal hypertension is an independent predictor of acute renal failure; (11). monitoring of abdominal perfusion pressure can be useful; and (12). intraabdominal hypertension triggers bacterial translocation and multiple organ system failure.

SUMMARY:

The answer is that it is unwise not to measure intraabdominal pressure in the ICU or even not to think about it.

PMID:
15075724
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center