Increased intra-abdominal pressure - An important risk factor of early organ dysfunction in severe acute pancreatitis

Guntars Pupelis, E. Autrums, K. Snippe, I. Melbarde-Gorkusa

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Background: Sustained increase of the intra-abdominal pressure is recently recognized as a potential risk factor of early organ dysfunction in patients with severe acute pancreatitis. Assessment of the possible mutual relevance between increased intra-abdominal pressure and early organ dysfunction is important for optimisation of the treatment strategy in this category of patients. Patients and methods: 71 patients with severe acute pancreatitis were entered in this prospective study. Clinical routine, sequential organ failure assessment score (SOFA), and intra-abdominal pressure were registered, considering 25 cm H2O a critical value for the grouping in high-risk (n = 18) and low-risk (n = 53) patients according to whether they experienced the critical level during their treatment course. Results: The age structure and the initial presentation of the organ dysfunction were similar between both groups. Progression of the organ dysfunction was observed in 61 % of the high-risk patients, compared to 32 % of low-risk patients, p < 0.05. Organ function improved after three to four day treatment only in survivors. Peak intra-abdominal pressure was greater in high-risk patients, p < 0.01, but declined after three to five day treatment period in all survivors, remaining critical in nonsurvivors. 78 % of high-risk and 32 % of low-risk patients were operated, p < 0.05. The overall mortality was 8.5 %, consisting of 2 % mortality in the low-risk group and 28 % mortality in the high-risk group, p < 0.01. Conclusion: Increased intra-abdominal pressure could be an important risk factor of early organ dysfunction in patients with severe acute pancreatitis. Critical increase of the intra-abdominal pressure and persisting organ dysfunction are an indication for reassessment of the treatment strategy.

Translated title of the contributionIncreased intra-abdominal pressure - An important risk factor of early organ dysfunction in severe acute pancreatitis
Original languageGerman
Pages (from-to)982-986
Number of pages5
JournalZentralblatt fur Chirurgie
Volume127
Issue number11
DOIs
Publication statusPublished - 1 Nov 2002
Externally publishedYes

Keywords

  • Acute pancreatitis
  • Intra-abdominal pressure
  • Treatment strategy

Field of Science

  • 3.2 Clinical medicine

Publication Type

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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