Abstract: Background and Aim:
Abdominal trauma can result in the increase of intra-abdominal pressure (IAP) for a variety of reasons including the accumulation of blood or free fluid in the peritoneal cavity, oedema of the intestinal wall, retroperitoneal hematoma or abdominal packing for haemorrhage control. The aim was to study the role of intra-abdominal pressure (IAP) monitoring in the management of patients with blunt injury abdomen.
Material and Methods: Hospital based prospective observational study in 100 patients who presented to emergency medicine department later shifted to department of general surgery in Tertiary care Institute of India, over a period of 18 months. IAP was measured in emergency medicine department and ICU at presentation, that is, 0 hours, 3 hours, 6 hours, 12 hours, 24 hours, 48 hours, 72 hours and 96 hours. Parameters noted were blood pressure, pulse rate, respiratory rate, oxygen saturation (SpO2), urine output, blood urea, serum creatinine, IAP, time of presentation to hospital after injury, duration of ICU and hospital stay, need for ventilatory support, morbidity (new organsystem dysfunction) and mortality.
Results: Correlation between IAP and vital parameters, renal parameters at 0, 3, 6, 24 and 72 hours were found statistically significant. Observation between IAP and vital parameters, renal parameters at 12 hours all parameters are significant except IAP has weak positive correlation with DBP and this was found statistically insignificant. Hospital stay decreased as IAP increases in surgically intervened group because IAP returned to normal after surgical decompression, but this finding was statistically significant only at 72 hours in our study.
Conclusion: Before development of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS), the potential candidates should be offered surgical decompression at proper time.