Acute pancreatitis is one of the main causes of intra-abdominal hypertension, which may lead to multiple physiologic alterations.
Dr Jose Manuel Hidalgo Rosas and colleagues from Spain determined the relationship between acute pancreatitis, and intra-abdominal hypertension.
The research team evaluated the utility of intra-abdominal pressure as a marker of severity in acute pancreatitis.
The team involved 45 patients admitted for acute pancreatitis in prospective, observational study from 2002 to 2004.
The diagnostic criteria for acute pancreatitis were compatible clinical manifestations, and a 3-fold increase in serum amylase levels.
Severe pancreatitis was defined as Apache II score of 8 or more.
Intra-abdominal pressure was determined every 12 hours.
|Intra-abdominal pressure was greater in patients requiring vasoactive drugs|
The researchers used the maximum and the mean values for analysis, and correlated these with prognostic factors of acute pancreatitis.
The team observed a relationship between maximum intra-abdominal pressure and the typical prognostic factors of acute pancreatitis.
Maximum intra-abdominal pressure was related to the computed tomography severity index, and the number of complementary tests required.
The researchers noted that the maximum intra-abdominal pressure was greater in patients who died.
The maximum intra-abdominal pressure was greater in patients requiring vasoactive drugs.
A greater intra-abdominal pressure was observed by the team in patients with total parenteral nutrition, or operative treatment related to complications.
The team also found that the maximum intra-abdominal pressure was greater in patients who developed systemic inflammatory response syndrome.
Patients with multiorgan failure, and increase in number and/or volume of intra-abdominal collections showed increased intra-abdominal pressure.
The researchers identified a maximum intra-abdominal pressure in those who required aspiration of the necrosis for suspected infection.
In addition, patients presenting with microorganisms, and with positive blood cultures also had a maximum intra-abdominal pressure.
Dr Rosas' team concludes, “The maximum intra-abdominal pressure is a useful, inexpensive, and easy method to measure prognostic marker of the evolution and complications of acute pancreatitis.”