• Dushyant Iyer, Scott D'Amours, and Anders Aneman.
• The University of New South Wales, Sydney, NSW, Australia. anders.aneman@swsahs.nsw.gov.au.
• Crit Care Resusc. 2014 Sep 1;16(3):214-9.

ObjectiveTo investigate screening variables identifying patients at risk of developing intra-abdominal hypertension (IAH) after cardiac surgery.Design And SettingProspective observational study in a tertiary general intensive care unit.ParticipantsOne hundred and eight patients admitted to the ICU after cardiac surgery, with measurements of intraabdominal pressure (IAP).Main Outcome MeasuresRoutinely collected clinical, physiological and biochemical variables were analysed with at least twice-daily measurements of IAP during the postoperative stay in the ICU. Variables available within 24 hours of admission to the ICU were evaluated against the incidence of IAH using logistic regression analysis to develop a set of screening criteria to identify patients at risk.ResultsFifty patients (46%) developed IAH during their stay in the ICU and were ventilated for longer, needed more vasopressors and stayed one more day in the ICU. Plasma albumin concentration, central venous pressure, minimal abdominal perfusion pressure, cardiopulmonary and aortic cross-clamp times and the presence of abdominal distension within the first 24 hours were associated with the occurrence of IAH. A logistic regression model using these variables correctly identified 85% of patients who developed IAH.ConclusionsA set of screening criteria routinely available within the first 24 hours of admission to the ICU after cardiac surgery could correctly identify most patients at risk of IAH.

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