Monitoring of letra-Abdominal Pressure and Clinical Challenges in Intensive Care-Unit Patients

摘要

Increased intra-abdominal pressure (IAP) may occur in a number of different situations encountered by intensivists, such as tense ascites, abdominal hemorrhage, use of military antishock trousers, abdominal obstruction, during lapa-roscopy, large abdominal tumors, and peritoneal dialysis [1-7]. Both clinical and experimental evidence support the hypothesis that an increase in IAP may affect cardiac, renal, respiratory, and metabolic functions [ 1 -12], as traditionally believed by most surgeons and intensivists. Nevertheless, increased IAP is rarely recognized and treated in intensive care unit (ICU) settings. This may be due to two different reasons: on the one hand the physiological consequences and the clinical importance of increased IAP are not well known to most physicians; on the other, the easy and precise measurement of IAP has not been well documented. Furthermore, the limits of increased IAP, above which it. is necessary to intervene, are not well established.