The duration of intra-abdominal hypertension strongly predicts outcomes for the critically ill surgical patients: a prospective observational study

被引:21
|
作者
Kyoung, Kyu-Hyouck [1 ]
Hong, Suk-Kyung [2 ]
机构
[1] Univ Ulsan, Ulsan Univ Hosp, Coll Med, Dept Surg, Ulsan, South Korea
[2] Univ Ulsan, Coll Med, Asan Med Ctr, Div Trauma & Surg Crit Care,Dept Surg, Seoul, South Korea
来源
关键词
Severe sepsis; Intra-abdominal hypertension; Intra-abdominal pressure; Enteral feeding; abdominal perfusion pressure; ABDOMINAL COMPARTMENT SYNDROME; INTERNATIONAL-CONFERENCE; RENAL-FUNCTION; SEVERE SEPSIS; PRESSURE; GUIDELINES; PERFUSION; EXPERTS;
D O I
10.1186/s13017-015-0016-7
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction: Intra-abdominal hypertension (IAH) is associated with morbidity and mortality in critically ill patients. The present study analyzed the clinical significance of IAH in surgical patients with severe sepsis. Methods: This was a prospective study carried out in the surgical intensive care unit (SICU). Intra-abdominal pressure (IAP) was measured three times a day via a urinary catheter filled with 25 mL of saline. IAH was defined as an IAP >= 12 mmHg, and the peak IAP was recorded as the IAP for the day. Data were analyzed in terms of IAH development and the IAH duration. Results: Of the 46 patients enrolled in the study, 42 developed IAH while in the SICU. The development of IAH aggravated the clinical outcomes; such as longer SICU stay, requirement of ventilator support, and delayed initiation of enteral feeding (EF). The IAH duration showed a significant correlation with pulmonary, renal, and cardiovascular function, and enteral feeding. The IAH duration was an independent predictor of 60-day mortality (odds ratio: 1.196; p = 0.014). Conclusions: The duration of IAH is a more important prognostic factor than the development of IAH; thus every effort should be made to reduce the IAH duration in critically ill patients.
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页数:6
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