• Émilie Richer-Séguin, Christian Ayoub, Jean-Sébastien Lebon, Jennifer Cogan, Stéphanie Jarry, Yoan Lamarche, André Y Denault, and William Beaubien-Souligny.
• Department of Anesthesia, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street, Montreal, QC, Canada.
• Can J Anaesth. 2022 Feb 1; 69 (2): 234-242.

PurposeWhile intra-abdominal hypertension (IAH) has been associated with adverse outcomes in multiple settings, the epidemiology and clinical implications of IAH in the context of cardiac surgery are less known. In this study, we aimed to describe the prevalence of IAH in patients undergoing cardiac surgery and determine its association with patient characteristics and postoperative outcomes.MethodsWe conducted a single-centre prospective cohort study in which intra-abdominal pressure was measured in the operating room after general anesthesia (T1), after the surgical procedure (T2), and two hours after intensive care unit (ICU) admission (T3) in a subset of patients. Intra-abdominal hypertension was defined as intra-abdominal pressure (IAP) ≥ 12 mm Hg. Postoperative outcomes included death, acute kidney injury (AKI), and length of stay in the ICU and hospital.ResultsA total of 513 IAP measurements were obtained from 191 participants in the operating room and 131 participants in the ICU. Intra-abdominal hypertension was present in 105/191 (55%) at T1, 115/191 (60%) at T2, and 31/131 (24%) at T3. Intra-abdominal pressure was independently associated with body mass index, central venous pressure, and mean pulmonary artery pressure but was not associated with cumulative fluid balance. Intraoperative IAH was not associated with adverse outcomes including AKI.ConclusionsIntra-abdominal hypertension is very common during cardiac surgery but its clinical implications are uncertain.© 2021. Canadian Anesthesiologists' Society.

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