• F Ruiz Ferrón, A Tejero Pedregosa, M Ruiz García, A Ferrezuelo Mata, J Pérez Valenzuela, R Quirós Barrera, and L Rucabado Aguilar.
• Servicio de Cuidados Críticos y Urgencias, Unidad de Medicina Intensiva, Hospital Médico-Quirúrgico, Complejo Hospitalario de Jaén, Jaén, España. frferron@terra.es
• Med Intensiva. 2011 Jun 1;35(5):274-9.

ObjectiveTo study the correlation between intraabdominal and intrathoracic pressure in patients with suspected intraabdominal hypertension.DesignA prospective, observational cohort study.SettingPolyvalent intensive care unit of a University hospital.PatientsTwenty-seven medical-surgical patient dependent upon controlled mechanical ventilation due to acute respiratory failure and with several risk factors for intraabdominal hypertension (IAH).Main VariablesIntraabdominal (IAP), esophageal (Peso) and airways pressure were measured under static (st) and dynamic (dyn) conditions. Respiratory system (Crs), lung (Cl) and chest wall compliance (Ccw)were calculated.ResultsIn 10 patients IAP > 12 mmHg (IAH, IAPst, 14 ± 2 [12-21] mmHg), while in the rest the pressure proved normal (n = 17; IAPst, 8 ± 2 [3-11] mmHg). Peso st was 11 ± 5 (2-27) and Peso dyn 7 ± 4 (2-24) cmH₂O. Depending on the presence or absence of IAH, Peso st was 9 ± 4 vs 7 ± 3 cmH₂O (p = 0.2) and Peso dyn 6 ± 2 vs 4 ± 3 cmH₂O (p = 0.3), respectively. The correlation between Peso st and dyn with IAPst was 0.5 (p= 0.003) and 0.4 (p = 0.03), respectively. The compliance components were decreased (Crs, 31 ± 8; Cl, 52 ± 22 and Ccw, 105 ± 50 ml/cmH₂O); Ccw was significantly lower in patients with IAH (81 ± 31 vs 118 ± 55 ml/cmH₂O; p = 0.02). The correlation coefficient between IAPst and Ccw was -0.7 (p < 0.001), and -0.5 (p = 0.002) with respect to Crs.ConclusionsA stiffer chest wall was observed in patients with IAH. In patients with risk factors for IAH, pressures in these compartments were highly variable.Copyright © 2009 Elsevier España, S.L. y SEMICYUC. All rights reserved.

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