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Highly Accessed Letter

A human model of intra-abdominal hypertension: even slightly elevated pressures lead to increased acute systemic inflammation and signs of acute kidney injury

Marije Smit1*, H Sijbrand Hofker2, Henri GD Leuvenink2, Christina Krikke2, Rianne M Jongman3, Jan G Zijlstra1 and Matijs van Meurs1

Author Affiliations

1 Department of Critical Care, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

2 Department of Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

3 Departments of Anesthesiology and Pathology and Medical Biology, Medical Biology Section, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

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Critical Care 2013, 17:425  doi:10.1186/cc12568

Published: 4 April 2013

First paragraph (this article has no abstract)

Intra-abdominal hypertension (IAH) may have catastrophic effects on critically ill patients, but its pathophysiology is only partially understood [1]. Oliguria and renal dysfunction are among the earliest signs of increasing intra-abdominal pressure (IAP) [2]. A number of different pathophysiological mechanisms may be responsible [1]. One of these may be an increase in pro-inflammatory cytokines provoked by IAH [2]. In IAPs of greater than 20 mm Hg, an increase in circulating levels of a variety of inflammatory mediators has been described [3].