Intra-abdominal hypertension (IAH) is frequently present in the critically ill and is associated with increased morbidity and mortality. Conventionally, intermittent ‘spot-check’ manual measurements of bladder pressure in those perceived as high risk are used as surrogates for intra-abdominal pressure (IAP). True patterns of IAH remain unknown. We explored the incidence of IAH in cardiac surgery patients and describe the intra-and postoperative course of IAP using a novel, high frequency, automated bladder pressure measurement system. Sub-analysis of a prospective, multicenter, observational study (NCT04669548) conducted in three large academic medical centers. Continuous urinary output (CUO) and IAP measurements were observed using the Accuryn Monitoring System (Potrero Medical, Hayward, CA). Data collected included demographics, hemodynamic support, and high-frequency IAP and CUO. One Hundred Thirty-Seven cardiac surgery patients were analyzed intraoperatively and followed 48 h postoperatively in the intensive care unit. Median age was 66.4 [58.3, 72.0] years, and 61% were men. Median Foley catheter dwell time was 56.0 [46.8, 77.5] hours, and median baseline IAP was 6.3 [4.0, 8.1] mmHg. 93% (128/137) of patients were in IAH grade I, 82% (113/137) in grade II, 39% (53/137) in grade III, and 5% (7/137) in grade IV for at least 12 cumulative hours. For maximum consecutive duration of IAH, 84% (115/137) of patients spent at least 12 h in grade I, 62% (85/137) in grade II, 18% (25/137) in grade III, and 2% (3/137) in grade IV IAH. During the first 48 h after cardiac surgery, IAH is common and persistent. Improved and automated monitoring of IAP will increase the detection of IAH—which normally would remain undetected using traditional intermittent monitoring methods.

腹内高压 (IAH) 经常出现在危重病人中，并且与发病率和死亡率增加有关。通常，间歇性“抽查”手动测量那些被认为是高风险的膀胱压力被用作腹内压 (IAP) 的替代指标。IAH 的真实模式仍然未知。我们探讨了 IAH 在心脏手术患者中的发病率，并使用一种新型的高频自动膀胱压力测量系统描述了 IAP 的术中和术后过程。在三个大型学术医学中心进行的前瞻性、多中心、观察性研究 (NCT04669548) 的子分析。使用 Accuryn 监测系统 (Potrero Medical, Hayward, CA) 观察连续尿量 (CUO) 和 IAP 测量值。收集的数据包括人口统计数据，血流动力学支持，以及高频 IAP 和 CUO。137 名心脏手术患者在术中进行了分析，并在重症监护室进行了术后 48 小时的随访。中位年龄为 66.4 [58.3, 72.0] 岁，61% 为男性。中位 Foley 导管停留时间为 56.0 [46.8, 77.5] 小时，中位基线 IAP 为 6.3 [4.0, 8.1] mmHg。在 at累计至少 12 小时。对于 IAH 的最长连续持续时间，84% (115/137) 的患者在 I 级至少持续 12 小时，62% (85/137) 在 II 级，18% (25/137) 在 III 级，2% (3/137) IV 级 IAH。在心脏手术后的最初 48 小时内，IAH 很常见且持续存在。