Influence of intra-abdominal pressure and perfusion on outcome in patients after emergency mayor intra-abdominal surgery

There is a relatively high risk of complications after emergency mayor intraabdominal surgery. Intra-abdominal hypertension and related hypoperfusion on splanchnic organs are one of the factors that may cause, at the end, the multiple organ failure syndrome. The aim of this study was to evaluate the influence of intra-abdominal pressure and perfusion on outcome in patients after emergency mayor intra-abdominal surgery. The preliminary results of this prospective study included 20 patients (13 male and 7 female, average age 66.35 +/- 16.33). The patients were divided in two goups, in view of the outcome, died (30%) and recovered (70%). All patients underwent intensive care treatment. There were no statistically significant differences between the two groups of patients in age, gender or duration of ICU stay. Postoperative were detected IAP, APP and SOFA score. Only one patient had IAP higher than 20 mm Hg at least once in the course of the study. In the group of patients who died (6 pts) on the day of admission APP was less then 60 mm Hg in three patients, but it showed increase in further period. IAP and APP were not predictiue for outcome in the preliminary results of an ongoing trial. Statistically significant difference in SOFA score wasn't found between the two groups of patients. However, it seems rightly to measure IAP and calculate APP in ICU patients after emergency mayor intrabdominal surgery because of the influence of higher values of IAP on all organ systems, especially in presence of other risky factors so that would be easier to consider all further treatment options.