Valor predictivo de la presión intra-abdominal en el diagnóstico de complicaciones posoperatorias abdominales

aimed at determining the diagnostic discrimination of the measurement of the intra-abdominal pressure in the diagnosis of postoperative intra-abdominal complications, it was designed a screening study that included 190 patients operated on of abdominal surgery that were admitted at "dr. luis díaz soto" higher institute of military medicine between may 2000 and december 2005. the study had two phases. in the first, designed to find out the normal interval, the intra-abdominal pressure was measured by the vesical catheterization method in 100 patients operated on that were selected at random, with a satisfactory evolution. such an interval was in the range from 1 to 15 cm of h2o. in the second phase of the study, relaparotomy was used as a "gold test", and the intra-abdominal pressure was measured previous to the operation of 90 patients with unfavorable postoperative evolution that had to undergo surgery again. the patients who had emergency operations presented more complications (67.8 %) than those who underwent elective surgery (32.2 %). it was observed a prevalence of infectious intra-abdominal complications (54.5 %). the diagnostic discrimination of the test allowed its use with a high degree of reliability and accuracy for the diagnosis of postoperative intra-abdominal complications. there was a considerable relationship between intra-abdominal pressure, respiratory frequency, diuresis and po2/fio2 ratio.