INTRA‐ABDOMINAL PRESSURE AND RENAL FUNCTION AFTER SURGERY TO THE ABDOMINAL AORTA

Publisher Website
Google Scholar
Abstract
It has been suggested that an elevated intra‐abdominal pressure (IAP) can impair renal function. In a prospective longitudinal study, the IAP of 42 patients admitted to an intensive care unit after abdominal aortic surgery was monitored. When compared with the other patients, the 22 patients (53%) who developed renal impairment had higher IAP (17.8 ± 6.0 mmHg versus 14.1 ± 4.8 mmHg: P < 0.01) and APACHE II scores (15.6 ± 6.0 versus 9.8 ± 4.6; P < 0.01). Each of the 10 patients who were re‐explored because of haemodynamic instability and oliguria had an IAP of > 18 mmHg (positive predictive value = 85%, negative predictive value = 62%). Following re‐exploration, the urinary output increased by 115 ± 40 mL/h (P < 0.01), and the IAP decreased by 10 ± 3 mmHg (P < 0.01). Although it is concluded that an IAP > 18 mmHg is a significant risk factor for the development of impaired renal function, it was not possible to prove a causal relationship between these events. Nevertheless, such a relationship has been demonstrated in animal and human models.