Intra-abdominal pressure (IAP) is seldom measured by default in intensive care patients. This review summarises the\r\ncurrent evidence on the prevalence and risk factors of intra-abdominal hypertension (IAH) to assist the decisionmaking\r\nfor IAP monitoring.\r\nIAH occurs in 20% to 40% of intensive care patients. High body mass index (BMI), abdominal surgery, liver\r\ndysfunction/ascites, hypotension/vasoactive therapy, respiratory failure and excessive fluid balance are risk factors of\r\nIAH in the general ICU population. IAP monitoring is strongly supported in mechanically ventilated patients with\r\nsevere burns, severe trauma, severe acute pancreatitis, liver failure or ruptured aortic aneurysms. The risk of\r\ndeveloping IAH is minimal in mechanically ventilated patients with positive end-expiratory pressure < 10 cmH2O,\r\nPaO2/FiO2 > 300, and BMI < 30 and without pancreatitis, hepatic failure/cirrhosis with ascites, gastrointestinal\r\nbleeding or laparotomy and the use of vasopressors/inotropes on admission. In these patients, omitting IAP\r\nmeasurements might be considered.\r\nIn conclusions, clear guidelines to select the patients in whom IAP measurements should be performed cannot be\r\ngiven at present. In addition to IAP measurements in at-risk patients, a clinical assessment of the signs of IAH\r\nshould be a part of every ICU patient�s bedside evaluation, leading to prompt IAP monitoring in case of the\r\nslightest suspicion of IAH development.
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