Clinical Significance of Intra-abdominal Hypertension in Surgical Patients With Severe Sepsis

Abscess, Bowel Perforation, Leakage, Peritonitis, Pneumonia

severe sepsis, intra-abdominal hypertension, intra-abdominal pressure

* Intra-abdominal pressure(IAP) is defined as a steady state pressure of the abdominal cavity * many studies have proved IAP as a prognostic factor that elevated IAP influences hemodynamics and multiple organs dysfunction * In previous studies, most of them was based on the septic patients of medical diseases. And it is rare about sepsis of surgical diseases such as traumatized or postoperative patients * We hypothesized that intra-abdominal hypertension may affect clinical course such as length of stay of intensive care unit, weaning of mechanical ventilation, proceeding of enteral feeding and mortality * Our study was aimed to investigate prevalence of IAH and risk factors and to analyze clinical course and prognosis influenced by IAH in surgical patients with severe sepsis

* Inclusion criteria older than 18 diagnosed as severe sepsis agreed on informed consent * Exclusion criteria refused to participate in the study traumatic injuries on urethra or bladder open abdomen status * Definition of severe sepsis organ failure more than one organ with sepsis arterial blood lactate concentration of at least 4mmol/L hypotension with a systolic blood pressure lower than 90mmHg * Definition of intra-abdominal hypertension intra-abdominal pressure more than 12mmHg * Measurement of IAP measuring via three lument urinary catheter measuring after filling with 25ml normal saline measuring in supine position at level of mid-axillary line on iliac crest measuring three times a day during ICU stay

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