Intra-abdominal pressure and abdominal perfusion pressure: which is a better marker of severity in patients with severe acute pancreatitis.

BACKGROUND

Intra-abdominal hypertension is common in patients with severe acute pancreatitis. The aim of this study was to assess the clinical relevance of intra-abdominal pressure and abdominal perfusion pressure in the first 72 h after admission during severe acute pancreatitis.

METHODS

From January 2009 to February 2011, 50 patients admitted for severe acute pancreatitis were included in this prospective, observational study. The intra-abdominal pressure and abdominal perfusion pressure level were repeatedly measured every 12 h during the first 72 h. The maximum and the mean values of intra-abdominal pressure and the minimum and mean values of abdominal perfusion pressure were used for analysis.

RESULTS

Both the maximum and mean levels of intra-abdominal pressure were significantly different between patients with or without kinds of clinical variables. But for abdominal perfusion pressure, difference could only be detected in terms of need of vasoactive drugs. Besides that, different from abdominal perfusion pressure, intra-abdominal pressure is associated with high incidence rates of MODS and secondary infection.

CONCLUSION

Compared with abdominal perfusion pressure, intra-abdominal pressure is much more valuable as an early marker of the evolution and complications of severe acute pancreatitis.