Intra-abdominal hypertension and hypoxic respiratory failure together predict adverse outcome - A sub-analysis of a prospective cohort
| Autor: | Yaset Caicedo, Mikhail Y. Kirov, Ana Albuquerque, Francisco Pracca, Dorota Siwicka-Gieroba, Ioana Grigoras, Liivi Maddison, Iroi Study Investigators, Anastasiya Kazlova, A. A. Smetkin, Carlos A. Ordoñez, Aliaksandr Filatau, Ülle Kirsimägi, Yana Y. Ilyina, Małgorzata Barud, Andrey Litvin, Anca Irina Ristescu, Gustavo Sosa, Gina Oliveira, Peter Vernon van Heerden, Kadri Tamme, Margaret M Morgan, Patrick Greiffenstein, Wendy A. Davis, Maicol Dos Santos, Bart De Keulenaer, Adrian Regli, Daniel Gilsdorf, Annika Reintam Blaser, Joel Starkopf, Edit Tidrenczel, Wojciech Dabrowski, Zsolt Bodnár, Annamaria Palermo, Adina Blejusca, Bruno M. Pereira, Manu L N G Malbrain, Edward J. Kimball |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Adverse outcomes medicine.medical_treatment Respiratory failure Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Mechanical ventilation Risk Factors Internal medicine medicine Humans Prospective Studies Prospective cohort study Critically ill Intra abdominal pressure Outcome Intra-abdominal pressure Acute respiratory distress syndrome business.industry 030208 emergency & critical care medicine Oxygenation Intra-abdominal hypertension 030228 respiratory system Risk factors Cardiology Intra-Abdominal Hypertension Blood Gas Analysis business Respiratory Insufficiency |
| Zdroj: | Journal of Critical Care r-FISABIO. Repositorio Institucional de Producción Científica instname |
| ISSN: | 1557-8615 |
| Popis: | Purpose: To assess whether the combination of intra-abdominal hypertension (IAH, intra-abdominal pressure >_ 12 mmHg) and hypoxic respiratory failure (HRF, PaO2/FiO2 ratio < 300 mmHg) in patients receiving invasive ventilation is an independent risk factor for 90-and 28-day mortality as well as ICU-and ventilation-free days. Methods: Mechanically ventilated patients who had blood gas analyses performed and intra-abdominal pressure measured, were included from a prospective cohort. Subgroups were defined by the absence (Group 1) or the presence of either IAH (Group 2) or HRF (Group 3) or both (Group 4). Mixed-effects regression analysis was performed. Results: Ninety-day mortality increased from 16% (Group 1, n = 50) to 30% (Group 2, n = 20) and 27% (Group 3, n = 100) to 49% (Group 4, n = 142), log-rank test p < 0.001. The combination of IAH and HRF was associated with increased 90-and 28-day mortality as well as with fewer ICU-and ventilation-free days. The association with 90-day mortality was no longer present after adjustment for independent variables. However, the association with 28-day mortality, ICU-and ventilation-free days persisted after adjusting for independent variables. Conclusions: In our sub-analysis, the combination of IAH and HRF was not independently associated with 90-day mortality but independently increased the odds of 28-day mortality, and reduced the number of ICU-and ventilation-free days. (c) 2021 Elsevier Inc. All rights reserved. |
| Databáze: | OpenAIRE |
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