Elevated intra-abdominal pressure in acute decompensated heart failure

被引:310
|
作者
Mullens, Wilfried [1 ]
Abrahams, Zuhelr [1 ]
Skouri, Hadi N. [1 ]
Francis, Gary S. [1 ]
Taylor, David O. [1 ]
Starling, Randall C. [1 ]
Paganini, Emil [2 ]
Tang, W. H. Wilson [1 ]
机构
[1] Cleveland Clin, Sect Heart Failure & Cardiac Transplant, Cleveland, OH 44106 USA
[2] Cleveland Clin, Sect Nephrol & Hypertens, Cleveland, OH 44106 USA
关键词
D O I
10.1016/j.jacc.2007.09.043
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives This study sought to determine whether changes in intra-abdominal pressure (IAP) with aggressive diuretic or vasodilator therapy are associated with improvement in renal function in acute decompensated heart failure (ADHF). Background Elevated IAP (>= 8 mm Hg) is associated with intra-abdominal organ dysfunction. There is potential for ascites and visceral edema causing elevated IAP in patients with ADHF. Methods Forty consecutive patients admitted to a specialized heart failure intensive care unit for management of ADHF with intensive medical therapy were studied. The IAP was measured using a simple transvesical technique at time of admission and before removal of the pulmonary artery catheter. Results In our study cohort (mean age 59 +/- 13 years, mean left ventricular ejection fraction 19 +/- 9%, baseline serum creatinine 2.0 +/- 0.9 mg/dI), the mean baseline IAP was 8 +/- 4 mm Hg, with 24 (60%) patients having elevated IAP. Elevated IAP was associated with worse renal function (p = 0.009). Intensive medical therapy resulted in improvement in both hemodynamic measurements and IAP. A strong correlation (r = 0.77, p < 0.001) was observed between reduction in IAP and improved renal function in patients with baseline elevated IAP. However, changes in IAP or renal function did not correlate with changes in any hemodynamic variable. Conclusions Elevated IAP is prevalent in patients with ADHF and is associated with impaired renal function. In the setting of intensive medical therapy for ADHF, changes in IAP were better correlated with changes in renal function than any hemodynamic variable.
引用
收藏
页码:300 / 306
页数:7
相关论文
共 50 条
  • [21] Elevated Intra-abdominal Pressure is a "Second-hit"
    Basu, Adhish
    WORLD JOURNAL OF SURGERY, 2010, 34 (05) : 1144 - 1144
  • [22] A simplified approach to the diagnosis of elevated intra-abdominal pressure
    Lee, SL
    Anderson, JT
    Kraut, EJ
    Wisner, DH
    Wolfe, BM
    JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2002, 52 (06): : 1169 - 1172
  • [23] Elevated intra-abdominal pressure:A review of current knowledge
    Piotr ?agosz
    Mateusz Sokolski
    Jan Biegus
    Agnieszka Tycinska
    Robert Zymlinski
    World Journal of Clinical Cases, 2022, 10 (10) : 3005 - 3013
  • [24] Elevated Intra-abdominal Pressure is a “Second-hit”
    Adhish Basu
    World Journal of Surgery, 2010, 34 : 1144 - 1144
  • [25] Intra-abdominal pressure in severe acute pancreatitis
    Keskinen P.
    Leppaniemi A.
    Pettila V.
    Piilonen A.
    Kemppainen E.
    Hynninen M.
    World Journal of Emergency Surgery, 2 (1)
  • [26] Association of intra-abdominal pressure changes with early diuretic response and improvement of dyspnea in patients with acute heart failure
    Apostolou, E.
    Holevas, N.
    Bistola, V.
    Trogkanis, E.
    Perpinia, A.
    Karavidas, A.
    Bakosis, G.
    Thodi, M.
    Pyrgakis, V. N.
    Iliodromitis, E.
    Filippatos, G.
    Parissis, J.
    EUROPEAN HEART JOURNAL, 2018, 39 : 178 - 178
  • [27] INTRA-ABDOMINAL PRESSURE
    LIGHT, HG
    ROUTLEDGE, JA
    ARCHIVES OF SURGERY, 1965, 90 (01) : 115 - +
  • [28] INTRA-ABDOMINAL PRESSURE
    ASPDEN, R
    CLINICAL BIOMECHANICS, 1988, 3 (01) : 48 - 48
  • [29] Intra-abdominal pressure measurement: validation of intragastric pressure as a measure of intra-abdominal pressure
    Turnbull, D.
    Webber, S.
    Hamnegard, C. H.
    Mills, G. H.
    BRITISH JOURNAL OF ANAESTHESIA, 2007, 98 (05) : 628 - 634
  • [30] Intra-abdominal pressure, intra-abdominal hypertension, and pregnancy: a review
    Rosaleen Chun
    Andrew W Kirkpatrick
    Annals of Intensive Care, 2