DEVELOPMENT OF CARDIAC DYSFUNCTION IN MILITARY PERSONNEL WITH CHRONIC VS ACUTE INCREASES IN INTRA-ABDOMINAL PRESSURE

This study examines the development of cardiac dysfunction in military personnel with chronic versus acute increases in intra-abdominal pressure (IAP). Intra-abdominal hypertension (IAH) has been associated with significant cardiovascular complications, including impaired myocardial function and hemodynamic instability. The study compares two groups of military patients—those with chronic IAP elevations, often due to repeated abdominal trauma or surgeries, and those with acute IAP increases following traumatic injuries or emergency surgeries. Using a retrospective cohort design, we assessed cardiovascular parameters, including cardiac output, myocardial contractility, and central venous pressure, in both groups. Additionally, we evaluated the incidence of multi-organ dysfunction and the impact on mortality. Our findings suggest that chronic increases in IAP result in gradual deterioration of myocardial function, with a higher incidence of sustained cardiac dysfunction and complications such as arrhythmias and heart failure compared to acute increases in IAP. In contrast, acute increases in IAP, although leading to transient myocardial dysfunction, showed a higher degree of hemodynamic instability and a more severe impact on organ function in the immediate post-trauma or post-surgery period. The study highlights the importance of early recognition and management of elevated IAP in military settings, emphasizing that both chronic and acute elevations pose distinct challenges to cardiovascular health. Timely intervention, including non-invasive monitoring and pharmacologic treatment, is essential to prevent irreversible cardiac damage and improve survival outcomes in military personnel exposed to high-risk environments.