Abdominal hypertension

PulmCrit

Killer resuscitation: Abdominal hypertension as an occult driver

of multiorgan failure 

PulmCrit - February 27, 2017 - By Josh Farkas

"Summary: The Bullet

• Intraabdominal hypertension is common among septic patients receiving large-volume resuscitation, but usually overlooked.
• Intraabdominal hypertension may cause occult organ injury (especially kidney injury), even in the absence of frank abdominal compartment syndrome.
• Diagnosing intraabdominal hypertension may identify patients at risk from further fluid administration. Such patients may benefit instead from volume removal.
• Abdominal perfusion pressure is equal to the abdominal pressure subtracted from the MAP, analogous to cerebral perfusion pressure. Maintaining an abdominal perfusion pressure >60 mm might be beneficial.
• The best approach to intraabdominal hypertension is prevention, by using a conservative fluid resuscitation strategy."