Predictive Ability of Intra-Abdominal Pressure for Mortality in Patients With Severe Acute Pancreatitis
Predictive Ability of Intra-Abdominal Pressure for Mortality in Patients With Severe Acute Pancreatitis
Severe Acute Pancreatitis (SAP) is an acute inflammatory condition of the pancreas
 characterized by organ dysfunction and increased mortality. Increased Intra-abdominal
 Pressure(IAP) in SAP is a result of inflammation of pancreatic and peripancreatic tissue,
 aggressive fluid resuscitation and increased capillary permeability, which is associated with
 organ dysfunction, by limiting the vascular supply to the tissue. Abdominal Compartment
 Syndrome (ACS) is defined as IAP greater than 20 mm of Hg and is considered an abdominal
 catastrophe. Intra-abdominal Hypertension (IAH, Intra-abdominal pressure > 12mm of Hg), may
 contribute to early organ dysfunction, ACS and eventually hemodynamic collapse if left
 untreated. This signifies the need for determining the burden of the condition and
 identifying the high risk patient group who are prone to develop IAH /ACS and predicting
 mortality associated with the condition. Measurement of IAP will be done indirectly by
 measuring intravesicular pressure using modified kron's method. IAP will be measured at the
 time of admission into Intensive Care Unit (ICU) and every day thereafter during the initial
 five days of ICU admission. Any reading of IAP ≥12 mm of Hg shall be considered as IAH. SOFA
 and APACHE II score will be noted on the day of admission in the ICU. Any interventions,
 surgical or non surgical as per clinician's decision will be recorded. The patients will be
 followed up until discharge or mortality until 30 days. The proposed study aims to assess the
 predictive ability of IAP during the first 5 days of ICU admission for predicting mortality
 in patients with SAP. Prediction accuracy will also be compared with SOFA and APACHE II
 scores.
Inclusion Criteria:

 >Patients with severe acute pancreatitis in the age group of 18-65 years admitted to ICU
 within 72 hours of onset of symptoms

 Exclusion Criteria:

 -  Previous history of any abdominal or pelvic surgery

 -  Known case of bladder tumor or bladder abnormality.

 -  Difficulty in urinary catheterization

 -  Use of neuromuscular blockade

 -  Pregnant patients