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

Research output: Contribution to journalScientific review

130 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)132-145
Number of pages14
JournalCurrent Opinion in Critical Care
Volume10
Issue number2
Publication statusPublished - Apr 2004

Keywords

  • Abdomen
  • Animals
  • Compartment Syndromes
  • Humans
  • Incidence
  • Intensive Care Units
  • Monitoring, Physiologic
  • Pressure
  • Prevalence

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