open access

Vol 47, No 4 (2015)
Review articles
Published online: 2015-05-13
Submitted: 2015-04-06
Accepted: 2015-05-13
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Abdominal signs and symptoms in intensive care patients

Annika Reintam Blaser, Joel Starkopf, Manu L.N.G. Malbrain
DOI: 10.5603/AIT.a2015.0022
·
Anaesthesiol Intensive Ther 2015;47(4):379-387.

open access

Vol 47, No 4 (2015)
Review articles
Published online: 2015-05-13
Submitted: 2015-04-06
Accepted: 2015-05-13

Abstract

Abdominal problems, both as a primary reason for admission or developing as a part of multiple organ dysfunction syndrome during an ICU stay, are common in critically ill patients. The definitions, assessment, incidence and outcome of different abdominal signs, symptoms and syndromes are assessed in the current review. General abdominal signs and symptoms include abdominal pain and distension, as well as other signs assessed during the physical examination (e.g. palpation, percussion). Gastrointestinal (GI) symptoms include vomiting, high gastric residual volumes, diarrhoea, GI bleeding, paralysis of the lower GI tract, bowel dilatation and absent bowel sounds. Although around half of patients suffer from these symptoms, the reported incidences of single symptoms vary within a large range due to variable definitions and case-mix. In a few studies, the total number of coincident GI symptoms was associated with increased mortality. Although acute abdomen is a well-recognized severe syndrome in emergency medicine, its incidence in ICUs is not known. Next to subjective clinical evaluation, intra-abdominal pressure, as a reproducible numerical variable, provides useful assistance in the assessment of the abdominal compartment, whereas intra-abdominal hypertension has been shown to impair the outcome of the critically ill. In conclusion, abdominal symptoms occur in half of patients in ICUs. Clinical evaluation, albeit largely subjective, remains the main bedside tool to detect abdominal problems and to assess GI function in the critically ill. IAP is a useful additional tool in the assessment of abdominal complications in ICUs.

Abstract

Abdominal problems, both as a primary reason for admission or developing as a part of multiple organ dysfunction syndrome during an ICU stay, are common in critically ill patients. The definitions, assessment, incidence and outcome of different abdominal signs, symptoms and syndromes are assessed in the current review. General abdominal signs and symptoms include abdominal pain and distension, as well as other signs assessed during the physical examination (e.g. palpation, percussion). Gastrointestinal (GI) symptoms include vomiting, high gastric residual volumes, diarrhoea, GI bleeding, paralysis of the lower GI tract, bowel dilatation and absent bowel sounds. Although around half of patients suffer from these symptoms, the reported incidences of single symptoms vary within a large range due to variable definitions and case-mix. In a few studies, the total number of coincident GI symptoms was associated with increased mortality. Although acute abdomen is a well-recognized severe syndrome in emergency medicine, its incidence in ICUs is not known. Next to subjective clinical evaluation, intra-abdominal pressure, as a reproducible numerical variable, provides useful assistance in the assessment of the abdominal compartment, whereas intra-abdominal hypertension has been shown to impair the outcome of the critically ill. In conclusion, abdominal symptoms occur in half of patients in ICUs. Clinical evaluation, albeit largely subjective, remains the main bedside tool to detect abdominal problems and to assess GI function in the critically ill. IAP is a useful additional tool in the assessment of abdominal complications in ICUs.

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Keywords

abdominal signs, abdominal symptoms, abdominal syndromes, abdominal hypertension, vomiting, diarrhoea, bleeding, paralysis, ileus, bowel dilatation, bowel sounds, gastric residual volume

About this article
Title

Abdominal signs and symptoms in intensive care patients

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 47, No 4 (2015)

Pages

379-387

Published online

2015-05-13

DOI

10.5603/AIT.a2015.0022

Bibliographic record

Anaesthesiol Intensive Ther 2015;47(4):379-387.

Keywords

abdominal signs
abdominal symptoms
abdominal syndromes
abdominal hypertension
vomiting
diarrhoea
bleeding
paralysis
ileus
bowel dilatation
bowel sounds
gastric residual volume

Authors

Annika Reintam Blaser
Joel Starkopf
Manu L.N.G. Malbrain

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