The influence of fluid balance on intra-abdominal pressure after major abdominal surgery

Medicina (Kaunas). 2008;44(6):421-7.

Abstract

Objective: The objectives of this study were to determine the incidence of intra-abdominal hypertension in patients after major abdominal surgery and to evaluate the correlation of intra-abdominal pressure with fluid balance and systemic inflammatory response syndrome.

Material and methods: This is a prospective observational study. Patients, admitted to intensive care unit after major abdominal surgery, were included into the study. Intra-abdominal pressure was measured via a urinary bladder catheter twice daily. Twenty-four-hour fluid balance and systemic inflammatory response syndrome criteria met by the patients were collected daily.

Results: Seventy-seven patients were included into the study. Intra-abdominal hypertension was diagnosed in about 40% of the patients in the early postoperative period. The study showed a significant positive correlation between 24-hour fluid balance and daily changes in intra-abdominal pressure. A significant association was also seen between the number of positive systemic inflammatory response syndrome criteria and intra-abdominal pressure, and intra-abdominal pressure was significantly higher in patients with systemic inflammatory response syndrome. Besides, patients with intra-abdominal hypertension on the first postoperative day had longer length of stay in the intensive care unit.

Conclusions: Intra-abdominal hypertension occurs commonly in patients after major abdominal surgery, and patients with positive 24-hour fluid balance and/or systemic inflammatory response syndrome are at risk of having higher intra-abdominal hypertension.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • APACHE
  • Abdomen / physiopathology
  • Abdomen / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Compartment Syndromes* / physiopathology
  • Data Interpretation, Statistical
  • Female
  • Humans
  • Hydrostatic Pressure
  • Intensive Care Units
  • Length of Stay
  • Male
  • Middle Aged
  • Pressure
  • Prospective Studies
  • Risk Factors
  • Systemic Inflammatory Response Syndrome*
  • Time Factors
  • Water-Electrolyte Balance*