ABSTRACT
E levated intra-abdominal pressure (LAP) is commonly encountered in the critically ill and is associated with significant morbidity and mortality. The “critical LAP” that causes end-organ dysfunction varies from patient to patient as a result of each individuals physiology and preexisting comorbidities. As a result, a single threshold value of LAP cannot be globally applied to the decision making of all critically ill patients. Calculation of “abdominal perfusion pressure” (APP), defined as mean arte rial pressure (MAP) minus LAP, assesses not only the severity of LAP present, but also the adequacy of the patient’s abdominal blood flow. APP is superior to both LAP and global resuscitation endpoints such as arterial pH, base deficit, and arterial lactate in its ability to both predict patient outcome and serve as a useful parameter for guiding the resuscitation and management of the patient with 1AH or ACS.
