Measurement of Intra Abdominal Pressure in Acute Pancreatitis and Correlation with Parameters and Outcomes

Backgraund Intra-abdominal pressure (IAP) is the steady-state pressure concealed within the abdominal cavity[1]. While the abdominal wall has elasticity, if intra-abdominal volume increases due to fluid, gas, pus, tissue oedema, high pressure leads to reduced blood flow and tissue ischemia which contributes to multiorgan failure. It is affected by body weight, posture, tension of abdominal muscles, and movement of the diaphragm[2-4]. Intra-abdominal hypertension (IAH) defined as an IAP ≥12 mmHg, and abdominal compartment syndrome as an IAP ≥ 20 mmHg combined with the failure of a new organ[5].. Material and Methods - It is a prospective descriptive observation study conducted in subharti hospital Meerut, UP, on 61 participants during a period of 2 years. Intra-abdominal pressure was measured through a Foleys bladder catheter throughout their stay. Bladder pressure was compared with clinical parameters like mean arterial pressures (MAP), respiratory rate (RR), serum creatinine (SC), Blood pressure (BP), Abdominal girth (AG), SOFA and APACHE 2 SCORE, abdominal perfusion pressure (APP) and also with outcome. Result - Mean IAP score was 18.74 in BAT subjects. At the time of admission, mean Systolic blood pressure, and Hemoglobin (Hb) was 135.10mmHg and 10.44 gm/dl respectively. Mean serum creatinine was 5.37. In our study mean SOFA and APHACHE 2 score was 10.14±8.91 and 9.38±3.95 respectively. Mean ICU and Hospital Stay (in days) was 6.30±4.06 and 11.97±7.15 respectively. Mortality was reported among 8 subjects in our study out of which 1, 3, 1 and 3 subjects were having IAP grade 1, 2, 3 and 4 respectively. Mean SPO2 % decreases as the IAP grade increases with statistically significant difference (pless than0.01). Indicate subjects having IAP greater than20 cm of water underwent exploratory laparotomy. CONCLUSION: We found in this study, that high IAP in critically ill patients with acute pancreatitis correlates with the degree of organ dysfunction and length of inte