This prospective observational study will evaluate changes in intra-abdominal pressure in critically ill adult patients receiving continuous renal replacement therapy in the intensive care unit. Intra-abdominal pressure will be measured through the urinary bladder at predefined time points during therapy. The study will also assess the relationship between intra-abdominal pressure changes and clinical variables, including fluid balance, hemodynamic parameters, vasopressor requirement, urine output, severity scores, duration of renal replacement therapy, intensive care unit and hospital length of stay, and 30-day survival. No additional treatment or therapeutic intervention will be administered for research purposes.
Age 18 years or older
Admission to the intensive care unit
Receiving continuous renal replacement therapy (CRRT)
Presence of an indwelling urinary (Foley) catheter for intra-abdominal pressure measurement
Pregnancy
Open abdominal wound or open abdomen
Neurogenic bladder
History of bladder surgery
Adult critically ill patients admitted to the intensive care unit who receive continuous renal replacement therapy (CRRT) and meet the predefined eligibility criteria. Eligible patients will be enrolled consecutively and prospectively followed for intra-abdominal pressure measurements and relevant clinical outcomes.
Cohort
Prospective
Intravesical Intra-abdominal Pressure Measurement
Procedure/SurgeryIntravesical intra-abdominal pressure will be measured via the existing urinary catheter at baseline and at 6, 12, 24, 48, and 72 hours after initiation of continuous renal replacement therapy (CRRT). Measurements will be performed for study data collection only. No therapeutic intervention or modification of routine clinical management will be undertaken based solely on the study measurements.
Change in Intra-abdominal Pressure During Continuous Renal Replacement Therapy
Intra-abdominal pressure will be measured indirectly via the urinary bladder using the intravesical technique. Measurements will be obtained at baseline before initiation of continuous renal replacement therapy and at 6, 12, 24, 48, and 72 hours. The primary outcome is the change in intra-abdominal pressure over the 72-hour observation period.
Occurrence of intra-abdominal hypertension
Intra-abdominal hypertension will be defined as sustained or repeated intra-abdominal pressure ≥12 mmHg during the 72-hour observation period. The occurrence of intra-abdominal hypertension will be assessed using serial intravesical intra-abdominal pressure measurements obtained at the predefined study time points.
Duration of Continuous Renal Replacement Therapy
The total duration of continuous renal replacement therapy (CRRT) will be recorded from initiation to discontinuation during the intensive care unit stay.
Intensive Care Unit Length of Stay
The total length of stay in the intensive care unit (ICU) will be recorded from ICU admission to ICU discharge.
Hospital Length of Stay
The total duration of hospitalization will be recorded from hospital admission to hospital discharge.
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