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Purpose of review: This review focuses on the available literature published in the past 2 years. MEDLINE and PubMed searches were performed using intraabdominal pressure, intraabdominal hypertension, and abdominal compartment as search items. The aim was to find an answer to the question: "Is it wise not to measure or even not to think about intraabdominal hypertension in ICU?"

Recent findings: It is difficult to find a good gold standard for intraabdominal pressure measurement. Bladder pressure can be used as an intraabdominal pressure estimate provided it is measured in a reproducible way. Automated continuous intraabdominal pressure monitoring has recently become available. Key messages are (1) body mass index and fluid resuscitation are independent predictors of intraabdominal hypertension; (2) intraabdominal hypertension increases intrathoracic, intracranial, and intracardiac filling pressures; (3) transmural or transabdominal filling pressures combined with volumetric parameters better reflect preload; (4) volumetric target values need to be corrected for baseline ejection fractions; (5) intraabdominal hypertension decreases left ventricular, chest wall and total respiratory system compliance; (6) best positive end-expiratory pressure can be set to counteract intraabdominal pressure; (7) acute respiratory distress syndrome definitions should take into account best positive end-expiratory pressure and intraabdominal pressure but not wedge pressure; (8) lung protective strategies should aim at [DELTA]Pplat (plateau pressure - intraabdominal pressure); (9) intraabdominal hypertension causes atelectasis and increases extravascular lung water; (10) intraabdominal hypertension is an independent predictor of acute renal failure; (11) monitoring of abdominal perfusion pressure can be useful; and (12) intraabdominal hypertension triggers bacterial translocation and multiple organ system failure.

Summary: The answer is that it is unwise not to measure intraabdominal pressure in the ICU or even not to think about it.

(C) 2004 Lippincott Williams & Wilkins, Inc.