Intra-abdominal pressure in severe acute pancreatitis

Keskinen, Paivi; Leppaniemi, Ari; Pettila, Ville; Piilonen, Anneli; Kemppainen, Esko; Hynninen, Marja
January 2007
World Journal of Emergency Surgery;2007, Vol. 2, p2
Academic Journal
Background: Hospital mortality in patients with severe acute pancreatitis (SAP) remains high. Some of these patients develop increased intra-abdominal pressure (IAP) which may contribute to organ dysfunction. The aims of this study were to evaluate the frequency of increased IAP in patients with SAP and to assess the development of organ dysfunction and factors associated with high IAP. Methods: During 2001-2003 a total of 59 patients with severe acute pancreatitis were treated in the intensive care unit (ICU) of Helsinki University Hospital. IAP was measured by the intravesical route in 37 patients with SAP. Data from these patients were retrospectively reviewed. Results: Maximal IAP, APACHE II score, maximal SOFA score, maximal creatinine, age and maximal lactate were significantly higher in nonsurvivors. There was a significant correlation of the maximal IAP with the maximal SOFA, APACHE II, maximal creatinine, maximal lactate, base deficit and ICU length of stay. Patients were divided into quartiles according to the maximal IAP. Maximal IAP was 7-14, 15-18, 19-24 and 25-33 mmHg and the hospital mortality rate 10%, 12.5%, 22.2% and 50% in groups 1-4, respectively. A statistically significant difference was seen in the maximal SOFA, ICU length of stay, maximal creatinine and lactate values. The mean ICU-free days in groups 1-4 were 45.7, 38.8, 32.0 and 27.5 days, respectively. The difference between groups 1 and 4 was statistically significant. Conclusion: In patients with SAP, increased IAP is associated with development of early organ failure reflected in increased mortality and fewer ICU-free days. Frequent measurement of IAP during intensive care is important in optimizing abdominal perfusion pressure and recognizing patients potentially benefitting from decompressive laparotomy.


Related Articles

  • Abdominal Compartment Syndrome Is an Early, Lethal Complication of Acute Pancreatitis. BOONE, BRIAN; ZUREIKAT, AMER; HUGHES, STEVEN J.; MOSER, A. JAMES; YADAV, DHIRAJ; ZEH, HERBERT J.; LEE, KENNETH K. W. // American Surgeon;Jun2013, Vol. 79 Issue 6, p601 

    Data defining the optimal management of abdominal compartment syndrome resulting from acute pancreatitis are lacking. We investigated the outcomes of patients with acute pancreatitis who underwent surgery for treatment of abdominal compartment syndrome at a tertiary referral center. An...

  • Risk Factors of Abdominal Surgery in Patients with Collagen Diseases. Nakashima, Hideaki; Karimine, Nobuya; Asoh, Tsukasa; Ueo, Hiroaki; Kohnoe, Shunji; Mori, Masaki // American Surgeon;Sep2006, Vol. 72 Issue 9, p843 

    Patients with collagen diseases have been reported to demonstrate a greater risk when undergoing surgical operations. To determine the risk factors in abdominal surgery for patients with collagen diseases, 32 patients with collagen diseases who underwent abdominal surgery were analyzed for their...

  • Perfusion index as a possible predictor for postanesthetic shivering. Kuroki, Chiharu; Godai, Kohei; Hasegawa-Moriyama, Maiko; Kuniyoshi, Tamotsu; Matsunaga, Akira; Kanmura, Yuichi; Kuwaki, Tomoyuki // Journal of Anesthesia;Feb2014, Vol. 28 Issue 1, p19 

    Background: Postanesthetic shivering can be triggered by surgical stress and several aspects of anesthetic management and is frequently preceded by a decrease in peripheral blood flow due to thermoregulatory vasoconstriction. As perfusion index correlates with peripheral blood flow, we examined...

  • Risk factors and mortality after elective and emergent laparatomies for oncological procedures in 899 patients in the intensive care unit: a retrospective observational cohort study. Mallol, Montserrat; Sabaté, Antoni; Dalmau, Antonia; Koo, Maylin // Patient Safety in Surgery;2013, Vol. 7 Issue 1, p1 

    Background: Abdominal surgeries for cancer are associated with postoperative complications and mortality. A view of the success of anaesthetic, surgical and critical care can be gained by analyzing factors associated with mortality in patients admitted to intensive care units (ICUs). The...

  • Gangrenous Perforation Of Stomach. Malhorta, Naveen; Singla, Sham Lal; Marwah, Sanjay; Goel, Rahul; Marwah, Nisha; Taneja, Rashmi // Internet Journal of Anesthesiology;2008, Vol. 16 Issue 2, p15 

    A 15 years old patient was admitted in emergency department with complaints of pain in abdomen associated with abdominal distension since one day. Patients with suspected perforation of stomach should be taken up for urgent exploratory laparotomy to decrease the mortality. Such patients may be...

  • RCoA spring symposium: perioperative medicine.  // BJA: The British Journal of Anaesthesia;Dec2015, Vol. 115 Issue 6, pe963 

    No abstract available.

  • Early antibiotic treatment (prophylaxis) of septic complications in severe acute necrotizing pancreatitis: a prospective, randomized, multicenter study comparing two regimens with imipenem-cilastatin. Maraví-Poma, Enrique; Gener, Joan; Alvarez-Lerma, Francisco; Olaechea, Pedro; Blanco, Armando; Domínguez-Muñoz, J. Enrique; Maraví-Poma, Enrique; Domínguez-Muñoz, J Enrique; Spanish Group for the Study of Septic Complications in Severe Acute Pancreatitis // Intensive Care Medicine;Nov2003, Vol. 29 Issue 11, p1974 

    Objective: We compared two imipenem regimens for prevention of septic complications in patients with severe acute necrotizing pancreatitis (ANP).Design and Setting: Prospective, randomized open clinical trial involving intensive care units of 14 Spanish...

  • Influence of systolic-pressure-variation-guided intraoperative fluid management on organ function and oxygen transport. M. Buettner; W. Schummer; E. Huettemann; S. Schenke; N. van Hout; S. G. Sakka // BJA: The British Journal of Anaesthesia;Aug2008, Vol. 101 Issue 2, p194 

    Background Dynamic variables, for example, systolic pressure variation (SPV), are superior to filling pressures for assessing fluid responsiveness. We analysed the effects of SPV-guided intraoperative fluid management on organ function and perfusion when compared with routine care. Methods...

  • CME/CNE Questions.  // Critical Care Alert;Jul2009, Vol. 17 Issue 4, p32 

    A quiz concerning critical care medicine and pancreatitis is presented.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics