Prevalence and prognostic significance of high intra-abdominal pressure in critically ill patients in Assiut University Hospital

Abstract Background Intra-abdominal hypertension (IAH) is prevalent among patients admitted to the intensive care unit (ICU). There is still a debate regarding the independent impact of IAH on patients’ outcomes. Aim To gain more insight about the prevalence and outcome of IAH in patients admitted to the ICU. Patients and methods A prospective study that was conducted on patients admitted to the ICU. The IAP was measured for all patients using the classic method of Harrahill four times daily. The patients were divided into 2 groups according to the intra-abdominal pressure. Results This study included 85 critically ill patients. It was found that 46 patients (54.1%) had IAH. Patients with IAH had significantly higher central venous pressure, greater clinical severity scores, a longer ICU stay, a higher percentage of mechanical ventilation (MV) requirements, a longer MV duration, and a higher incidence of acute kidney injury (AKI). Central venous pressure (CVP) and AKI were significant predictors of IAH. IAH was a significant predictor of the patients’ mortality. Conclusion This study adds new evidence regarding the higher prevalence of IAH in critically ill patients. The primary contributors to IAH were IV fluid administration and obesity. IAH was associated with longer ICU stays, worse clinical conditions, a requirement for MV, prolonged MV duration, and AKI. The mean intra-abdominal pressure (MIAP) and AKI emerged as significant predictors of mortality.