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

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)822-829
Number of pages8
JournalIntensive Care Medicine
Volume30
Issue number5
DOIs
Publication statusPublished - May 2004

Keywords

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

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Malbrain, M. L. N. G., Chiumello, D., Pelosi, P., Wilmer, A., Brienza, N., Malcangi, V., Bihari, D., Innes, R., Cohen, J., Singer, P., Japiassu, A., Kurtop, E., De Keulenaer, B. L., Daelemans, R., Del Turco, M., Cosimini, P., Ranieri, M., Jacquet, L., Laterre, P. F., & Gattinoni, L. (2004). Prevalence of intra-abdominal hypertension in critically ill patients: A multicentre epidemiological study. Intensive Care Medicine, 30(5), 822-829. https://doi.org/10.1007/s00134-004-2169-9