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The impact of intra-abdominal pressure on urine output in postoperative cardiac surgery patients:Insights from continuous monitoring

Title: The impact of intra-abdominal pressure on urine output in postoperative cardiac surgery patients:Insights from continuous monitoring
Authors: Günther, F.; van Meurs, M.; Prasad, A.; Rivrud, S. C.S.; Nijsten, M. W.; Smit, M.; Koeze, J.
Source: Günther, F, van Meurs, M, Prasad, A, Rivrud, S C S, Nijsten, M W, Smit, M & Koeze, J 2026, 'The impact of intra-abdominal pressure on urine output in postoperative cardiac surgery patients : Insights from continuous monitoring', Journal of Critical Care, vol. 91, 155335. https://doi.org/10.1016/j.jcrc.2025.155335
Publication Year: 2026
Collection: University of Groningen research database
Subject Terms: Acute kidney failure; Acute kidney injury; Cardiac surgery; Intra-abdominal hypertension; Intra-abdominal pressure; Urine output
Description: Introduction: Acute kidney injury (AKI) is a multifactorial condition, with postoperative cardiac surgical patients representing a distinct subgroup of critically ill patients. This study aims to investigate the effect of intra-abdominal pressure (IAP) on urine output (UO) in postoperative cardiac surgical patients during their stay in the Intensive Care Unit (ICU). Methods: In this prospective pilot study, UO and IAP were measured continuously via the bladder in postoperative cardiac surgical patients using a novel monitoring device. Trends in IAP and UO were explored, and correlations between both their absolute values and their changes over time were assessed using Spearman's rank correlation. Finally, a linear mixed effect model was fitted to assess the effect of IAP on UO over time. Results: Thirty-six patients were included in this study, with a total of 3521 IAP measurements. The correlation between IAP and UO was −0.30 ( p < 0.001), while the correlation between changes in IAP and changes in UO was not statistically significant (0.02, p = 0.19). A multivariate linear mixed-effects model showed that IAP was independently and negatively associated with logarithmically transformed hourly UO. (β = −0.075, 95 %CI -0.098 - (−0.052), p < 0.001). One mmHg increase in IAP corresponded with an estimated 7 % decrease in UO. Conclusions: In this exploratory study, a linear mixed-effects model revealed a significant negative association between increased intra-abdominal pressure and urine output. However, not all potentially important factors influencing UO and IAP were included in this study, such as fluid balance or patient position. Urine output in postoperative cardiac surgery patients during their ICU stay appears to be influenced by multiple factors, highlighting the need for further research to better understand these associations.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 0883-9441
Relation: info:eu-repo/semantics/altIdentifier/pmid/41166889; info:eu-repo/semantics/altIdentifier/hdl/https://hdl.handle.net/11370/4143be03-274e-40b9-8836-5a5114038d9f; info:eu-repo/semantics/altIdentifier/pissn/0883-9441
DOI: 10.1016/j.jcrc.2025.155335
Availability: https://hdl.handle.net/11370/4143be03-274e-40b9-8836-5a5114038d9f; https://research.rug.nl/en/publications/4143be03-274e-40b9-8836-5a5114038d9f; https://doi.org/10.1016/j.jcrc.2025.155335; https://pure.rug.nl/ws/files/1494031469/1-s2.0-S0883944125003223-main.pdf; https://www.scopus.com/pages/publications/105020953848
Rights: info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.C5A4D88E
Database: BASE