Which of the following are complications of intra-abdominal hypertension?

• A. Acute kidney injury
• B. Reduced lung compliance
• C. Elevated airway pressures
• D. All of the above

Answer: (D)

Intra-abdominal hypertension stresses multiple organ systems by increasing pressure inside the abdomen, which impairs both perfusion and mechanics. It lowers renal perfusion pressure and raises renal venous pressure, so the kidneys receive less blood flow, predisposing to acute kidney injury if the pressure remains elevated. It also pushes the diaphragm upward, shrinking thoracic volume and reducing lung compliance, which makes ventilation harder and can worsen oxygenation. On a ventilator, the stiffer chest wall and lungs translate into higher airway pressures (peak and plateau pressures) needed to deliver the same tidal volume. Because these effects span renal, pulmonary, and ventilatory mechanics, all of the above are potential complications of intra-abdominal hypertension.