Intra-abdominal pressure correlates with extracellular water content

Wojciech Dąbrowski; Edyta Kotlinska-Hasiec; Andrzej Jaroszynski; Przemyslaw Zadora; Jacek Pilat; Ziemowit Rzecki; Wojciech Zaluska; Daniel Schneditz

doi:10.1371/journal.pone.0122193

Intra-abdominal pressure correlates with extracellular water content

PLoS One. 2015 Apr 7;10(4):e0122193. doi: 10.1371/journal.pone.0122193. eCollection 2015.

Authors

Wojciech Dąbrowski¹, Edyta Kotlinska-Hasiec¹, Andrzej Jaroszynski², Przemyslaw Zadora¹, Jacek Pilat³, Ziemowit Rzecki¹, Wojciech Zaluska⁴, Daniel Schneditz⁵

Affiliations

¹ Department of Anesthesiology and Intensive Therapy Medical University of Lublin, Lublin, Poland.
² Department of Family Medicine Medical University of Lublin, Lublin, Poland.
³ Department of General Surgery, Transplantology and Clinical Nutrition Medical University of Lublin, Lublin, Poland.
⁴ Department of Nephrology Medical University of Lublin, Lublin, Poland.
⁵ Department of Physiology, Medical University of Graz, Graz, Austria.

Abstract

Background: Secondary increase in intra-abdominal pressure (IAP) may result from extra-abdominal pathology, such as massive fluid resuscitation, capillary leak or sepsis. All these conditions increase the extravascular water content. The aim of this study was to analyze the relationship between IAP and body water volume.

Material and methods: Adult patients treated for sepsis or septic shock with acute kidney injury (AKI) and patients undergoing elective pharyngolaryngeal or orthopedic surgery were enrolled. IAP was measured in the urinary bladder. Total body water (TBW), extracellular water content (ECW) and volume excess (VE) were measured by whole body bioimpedance. Among critically ill patients, all parameters were analyzed over three consecutive days, and parameters were evaluated perioperatively in surgical patients.

Results: One hundred twenty patients were studied. Taken together, the correlations between IAP and VE, TBW, and ECW were measured at 408 time points. In all participants, IAP strongly correlated with ECW and VE. In critically ill patients, IAP correlated with ECW and VE. In surgical patients, IAP correlated with ECW and TBW. IAP strongly correlated with ECW and VE in the mixed population. IAP also correlated with VE in critically ill patients. ROC curve analysis showed that ECW and VE might be discriminative parameters of risk for increased IAP.

Conclusion: IAP strongly correlates with ECW.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Electric Impedance
Extracellular Space / metabolism*
Female
Humans
Intra-Abdominal Hypertension / diagnosis
Intra-Abdominal Hypertension / metabolism
Intra-Abdominal Hypertension / pathology*
Male
Middle Aged
ROC Curve
Water / metabolism*

Substances

Water

Grants and funding

This study was supported by Medical University of Lublin, Poland. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.