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Intra‐abdominal pressure, sagittal abdominal diameter and obesity comorbidity
Open accessAbstract
Objectives. To determine relationship of intraabdominal pressure to central obesity and the comorbidity of obesity. Design. Non‐randomized, prospective. Setting. University hospital, operating room. Subjects. Eighty‐four anaesthetized consecutive patients prior to gastric bypass for morbid obesity and five non‐obese patients before colectomy for ulcerative colitis. Main outcome measures. Weight, body mass index (BMI), co‐morbid history, sagittal abdominal diameter, waist:hip (W∶H) ratio and urinary bladder pressure, as an estimate of intra‐abdominal pressure. Results. Urinary bladder pressure was greater in the obese than the non‐obese (18±0.7 vs. 7±1.6 cm H 2 O, P < 0.001), correlated with sagittal abdominal diameter (r = +0.67, P < 0.001) and was greater (P < 0.05) in patients with, than those without, morbidity probably (hypoventilation, gastroesophageal reflux, venous stasis, stress incontinence, incisional hernia) or possibly (hypertension, diabetes) due to increased abdominal pressure. W∶H ratio correlated with urinary bladder pressure in men (r = +0.6, P < 0.05) but not women (r = −0.3). Conclusions. Increased sagittal abdominal diameter was associated with increased intraabdominal pressure which contributed to obesity‐related comorbidity. W∶H ratio was not a reliable indicator of intraabdominal pressure for women who often have both peripheral and central obesity. Further studies are needed to evaluate the relationship between intraabdominal pressure and Type II diabetes and hypertension.
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“In patients with visceral obesity, intra-abdominal pressure rises in proportion to sagittal abdominal diameter, reaching levels as high as 35–40 mmHg27.”
From Obesity-Induced Hypertension: Interaction of Neurohumoral and Renal Mechanisms (2015) · cites this paper as [27]
Experimental — accuracy not yet measuredIn the citing paper
“Pressure in the abdominal cavity may be elevated to >40 cm H20 in patients with large sagittal abdominal diameters52.”
From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [52]
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Hall, J. E., da Silva, A. A., Brandon, E. L., Stec, D. E., Ying, Z., & Jones, D. W. (2007) · Elsevier eBooks · doi:10.1016/b978-0-323-03961-1.50041-6 · Cited by 18
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Kreislaufstillstand unter besonderen Umständen
Soar, J., Deakin, C. D., Nolan, J. P., Abbas, G., Alfonzo, A. V. M., Handley, A. J., Lockey, D., Perkins, G. D., Thies, K., Böttiger, B. W., et al. (2006) · Notfall + Rettungsmedizin · doi:10.1007/s10049-006-0798-y · Cited by 17
Environmental Perturbations: Obesity
Shore, S. A. (2010) · Comprehensive physiology · doi:10.1002/cphy.c100017 · Cited by 18
Kahn, H. S., Rissanen, H. A., Bullard, K. M., et al. (2014) · Clinical Obesity · doi:10.1111/cob.12078 · Cited by 15
“Publications describing SAD in the supine position have used methods ranging from a carpenter’s level at the bedside (17,20,21) to cross-sectional abdominal imaging by magnetic resonance (4) or computerized tomography (22).”
Reliability of intrabladder pressure measurement in intensive care.
Shuster, M., Haines, T., Sekula, L. K., Kern, J. C., & Vazquez, J. A. (2010) · American Journal of Critical Care · doi:10.4037/ajcc2010204 · Cited by 15
Intra-abdominal Hypertension in Medical Critically Ill Patients: A Narrative Review
Ortiz-Diaz, E., & Lan, C. (2014) · Shock · doi:10.1097/shk.0000000000000100 · Cited by 14
Sun, J.-Y., Su, Z., Yang, J., Sun, W. Y., & Kong, X. (2024) · Life Sciences · doi:10.1016/j.lfs.2024.122511 · Cited by 14
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“Greater abdominal girth was associated with a more notable increase in the intra-abdominal pressure [17].”
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Gao, H., Jin, Z., Tang, K., Ji, Y., Suárez, J., Suárez, J., Rocha, K. C. E., Zhang, D., DILLMANN, W. H., Mahata, S. K., et al. (2022) · Journal of the American Heart Association · doi:10.1161/jaha.121.024561 · Cited by 17
“…Induces Adrenal Disorder sympathetic tone, 3– 5 overactivation of the renin– angiotensin system, 6 elevation of aldosterone levels, endothelial dysfunction, 7 and mechanical compression of the kidney, 8 it is yet to be established how obesity triggers the above changes to cause hypertension.”
Kotidis, E. V., Papavramidis, T. S., Ioannidis, K., Cheva, A., Lazou, T. P., Michalopoulos, N., Karkavelas, G., & Papavramidis, T. S. (2010) · Journal of Surgical Research · doi:10.1016/j.jss.2010.06.034 · Cited by 14
Najari, B. B., Katz, M. J., Schulster, M. L., et al. (2015) · Urology · doi:10.1016/j.urology.2015.11.033 · Cited by 14
Ceresoli, M., Salvetti, F., Kluger, Y. S., et al. (2019) · World Journal of Surgery · doi:10.1007/s00268-019-05209-2 · Cited by 14
Possible Assessment of Calf Venous Pump Efficiency by Computational Fluid Dynamics Approach
Niccolini, G., Bertetto, A. M., Capone, A., et al. (2020) · Frontiers in Physiology · doi:10.3389/fphys.2020.01003 · Cited by 13
Hiramoto, B. A., Flanagan, R. F., Muftah, M., Shah, E. D., & Chan, W. W. (2024) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2024.04.002 · Cited by 13
Varela, J. E., & Frey, W. (2011) · Obesity Surgery · doi:10.1007/s11695-011-0365-6 · Cited by 13
“[14].”
The Effects of Chronically Increased Intra-abdominal Pressure on the Rabbit Diaphragm
Papavramidis, T. S., Kotidis, E. V., Ioannidis, K., Cheva, A., Lazou, T. P., Koliakos, G., Karkavelas, G., & Papavramidis, T. S. (2012) · Obesity Surgery · doi:10.1007/s11695-012-0587-2 · Cited by 13
“Weight— and more specifically body mass index—is in linear relation with IAP [9], and therefore, any important variation of BMI may lead to important variation of IAP.”
BackgroundThe obesity supine death syndrome (OSDS)
Lemyze, M., Guiot, A., Mallat, J., et al. (2017) · Obesity Reviews · doi:10.1111/obr.12655 · Cited by 13
“Interestingly, a significant correlation has been identified between bladder pressures and sagittal abdominal diameter (31).”
BackgroundNagayoshi, K., Nagai, S., Hisano, K., Mizuuchi, Y., Fujita, H., & Nakamura, M. (2020) · Hernia · doi:10.1007/s10029-020-02192-9 · Cited by 13
A New Device for Measuring Abdominal Wall Tension and Its Value in Screening Abdominal Infection
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“Perhaps because the muscle layer plays a major role in the AWT, the AWT is not directly related to the degree of obesity but has individual differences.(21) The reason for the higher AWT in obese patients might be related to the reduction in shaping ability caused by high IAV and the increase in IAP in the resting sta…”
BackgroundDiaphragmatic Adaptation Following Intra-abdominal Weight Charging
Papavramidis, T. S., Kotidis, E. V., Ioannidis, K., Cheva, A., Lazou, T. P., Koliakos, G., Karkavelas, G., & Papavramidis, T. S. (2010) · Obesity Surgery · doi:10.1007/s11695-010-0334-5 · Cited by 13
“In the present study, the morphologic and biochemical analysis were performed on the costal portion of the diaphragm, since it is responsible for the respiratory function of the muscle [7, 22].”
BackgroundMethodVena cava compression syndrome in patients with obesity presenting with edema and thrombosis
Linicus, Y., Kindermann, I., Cremers, B., Maack, C., Schirmer, S. H., & Böhm, M. (2016) · Obesity · doi:10.1002/oby.21506 · Cited by 15
“Obesity is associated with raised intra-abdominal pressure and reduced venous blood flow velocity, which can increase the risk of clotting (14,15).”
BackgroundWilliams, K. N., Hussain, L. R., Fellner, A. N., et al. (2019) · Surgical Endoscopy · doi:10.1007/s00464-019-07129-7 · Cited by 13
Günüşen, İ., Sargın, A., & Akdemir, A. (2019) · TURKISH JOURNAL OF MEDICAL SCIENCES · doi:10.3906/sag-1804-167 · Cited by 12
“Many recent studies have addressed the effects of uterine size, abdominal girth, and IAP on sensory block level, ephedrine dose, and the incidence of hypotension in pregnant women.”
BackgroundInfluentialCardiovascular and hidroelectrolytic changes in rats fed with high-fat diet
Sá, J. M., Barbosa, R. M., Menani, J. V., Junior, L. A. D. L., Colombari, E., & Colombari, D. S. A. (2019) · Behavioural Brain Research · doi:10.1016/j.bbr.2019.112075 · Cited by 12
Intra-Abdominal Hypertension and the Abdominal Compartment Syndrome
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Chaichanavichkij, P., Vollebregt, P. F., Keshishian, K., Knowles, C. H., & Scott, S. M. (2023) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000002400 · Cited by 11
When Pandemics Collide: the Interplay of Obesity and COVID-19
Mundi, M. S., Patel, J. J., Elfadil, O. M., Patel, J., Patel, I. K., Nanda, S., & Hurt, R. T. (2021) · Current Gastroenterology Reports · doi:10.1007/s11894-021-00822-5 · Cited by 11
BMI, Waist Circumference, and Incident Urinary Incontinence in Older Women
Townsend, M. K., Curhan, G. C., Resnick, N. M., & Grodstein, F. (2008) · Obesity · doi:10.1038/oby.2008.153 · Cited by 10
Kesıcı, U., Kesi̇ci̇, S., Polat, E., et al. (2011) · Saudi Medical Journal · doi:10.15537/1658-3175.5356 · Cited by 11
Krauß, P. E., Fritz-Naville, M., Regli, L., et al. (2017) · World Neurosurgery · doi:10.1016/j.wneu.2017.09.108 · Cited by 11
Mohan, S., Lim, Z. Y., Chan, K. S., & Shelat, V. G. (2023) · Life · doi:10.3390/life13020330 · Cited by 10
“There were three studies on ICU patients [10,12,17], three studies on bariatric surgery patients [8,11,16], two studies on cardiothoracic surgery patients [14,15], and one study on patients with acute pancreatitis (AP) [13].”
BackgroundResultInfluentialEffect of obesity on venous blood flow in the lower limbs
Langan, E. A., Wienandt, M., Bayer, A. U., Ellebrecht, L.-H., & Kahle, B. K. (2023) · JDDG Journal der Deutschen Dermatologischen Gesellschaft · doi:10.1111/ddg.15062 · Cited by 12
Smereczyński, A., Kołaczyk, K., & Bernatowicz, E. (2020) · Journal of Ultrasonography · doi:10.15557/jou.2020.0033 · Cited by 10
“Higher intra-abdominal pressure in obese patients compared to normal-weight individuals was reported by Sugerman et al.(20) and Wilson et al.(21), as opposed to Chena et al.(5) It seems that the absence of IAH in some of obese patients may be explained by overstretching and thinning of the abdominal wall.”
BackgroundVisceral fat is associated with cirrhotic portal vein thrombosis
Hernández‐Conde, M., Llop, E., Fernández‐Carrillo, C., Perelló, C., López-Gómez, M., Abad, J., Porras, J. L. M., Fernández-Puga, N., & Calleja, J. L. (2019) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2019.1651644 · Cited by 10
Metadata
- Authors
- SUGERMAN, H., WINDSOR, A., BESSOS, M., & WOLFE, L.
- Affiliations
- Virginia Commonwealth University (US)
- Corresponding author
- SUGERMAN, H.
- ORCID
- WINDSOR, A.
- Venue
- Journal of Internal Medicine
- Publisher
- Wiley
- Published
- 1997-01
- Volume
- 241
- Issue
- 1
- Pages
- 71-79
- ISSN
- 0954-6820 (ISSN-L)
- 1365-2796
- OpenAlex
- W1976707172
- Cited by
- 486
- References
- 0
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 13 · 2023: 15 · 2022: 9 · 2021: 25 · 2020: 14 · 2019: 16 · 2018: 19 · 2017: 18 · 2016: 20 · 2015: 30 · 2014: 19 · 2013: 16 · 2012: 21
- FWCI
- 11.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Abdominal Surgery and Complications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- intra-abdominal pressure, sagittal abdominal diameter, obesity-related comorbidities, abdominal obesity, bladder pressure, waist-to-hip ratio, morbid obesity, gastric bypass, ulcerative colitis, colectomy, obesity-related morbidity, sex differences
- MeSH terms
- Abdomen, Adult, Urinary Bladder, Female, Humans, Male, Obesity, Morbid, Prospective Studies
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