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

Observational Study of Relationship Between Intra-abdominal Hypertension and Severe Sepsis in Surgical Patients

• 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

Inclusion Criteria:

• older than 18-year
• agreed on informed consent
• diagnosed with severe sepsis

Exclusion Criteria:

• traumatic injuries on urethra or bladder
• open abdomen status