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

Mindaugas Šerpytis, Juozas Ivaškevičius

Clinic of Anesthesiology and Intensive Care, Vilnius University, Lithuania

Key words: intra-abdominal pressure; intra-abdominal hypertension; fluid balance; systemic inflammatory response syndrome.

Summary. 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.

Correspondence to M. Šerpytis, Clinic of Anesthesiology and Intensive Care, Vilnius University, Šiltnamių 29, 04130 Vilnius, Lithuania. E-mail: mindaugas.serpytis@santa.lt

Received 4 March 2008, accepted 10 June 2008