Intraabdominal Hypertension and the Critically Ill

• Intraabdominal hypertension (IAH) is increasingly recognized in a wide variety of critically ill patients and is associated with significant morbidity and mortality
• Normal intraabdominal pressure (IAP) is 5 - 7 mm Hg
• IAH is defined as the sustained elevation in IAP of at least 12 mm Hg
• Physical exam is inaccurate in detecting IAP with sensitivities of 40-60%
• The most common method of measuring IAP is intravesicular (bladder)
• Importantly, IAP should be measured at end-expiration after ensuring that abdominal muscle contractions are absent, with the patient in the supine position, and with the transducer zeroed in the midaxillary line at the level of the iliac crest

References

Cheatham ML. Intraabdominal pressure monitoring during fluid resuscitation. Curr Opin Crit Care 2008;14:327-33.