Incidence and prognosis of intraabdominal hypertension in a mixed population of critically ill patients: A multiple-center epidemiological study
| Autor: | Nicola Brienza, Bruno Mario Cesana, V. Marco Ranieri, Paolo Pelosi, Luc Jacquet, Vincenzo Malcangi, Bart De Keulenaer, Monica Del Turco, Davide Chiumello, Pierre-François Laterre, Manu L N G Malbrain, Jonathan Cohen, Günther Frank, Luciano Gattinoni, Richard Innes, Paulo Rogério N. de Souza, André M. Japiassú, Alexander Wilmer, Ronny Daelemans, David Bihari |
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| Přispěvatelé: | MALBRAIN ML, CHIUMELLO D, PELOSI P, BIHARI D, INNES R, RANIERI VM, DEL TURCO M, WILMER A, BRIENZA N, MALCANGI V, COHEN J, JAPIASSU A, DE KEULENAER BL, DAELEMANS R, JACQUET L, LATERRE PF, FRANK G, DE SOUZA P, CESANA B, GATTINONI L, Supporting clinical sciences, Intensive Care |
| Jazyk: | angličtina |
| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Multicenter Study APACHE Abdominal Cavity Aged Compartment Syndromes Hospital Mortality Intensive Care Units Water-Electrolyte Balance Multiple Organ Failure intraabdominal pressure Population Critical Care and Intensive Care Medicine law.invention intraabdominal hypertension surgery pressure critically ill patient law Intensive care medicine critical illness Humans risk factors Simplified Acute Physiology Score education intensive care Medicine(all) education.field_of_study business.industry Organ dysfunction Odds ratio Middle Aged Prognosis Intensive care unit Confidence interval Surgery abdominal compartment syndrome trauma Relative risk Emergency medicine Female medicine.symptom business |
| Popis: | Objective: Intraabdominal hypertension is associated with significant morbidity and mortality in surgical and trauma patients. The aim of this study was to assess, in a mixed population of critically ill patients, whether intraabdominal pressure at admission was an independent predictor for mortality and to evaluate the effects of intraabdominal hypertension on organ functions. Design: Multiple-center, prospective epidemiologic study. Setting: Fourteen intensive care units in six countries. Patients: A total of 265 consecutive patients admitted for >24 hrs during the 4-wk study period. Interventions: None. Measurements and Main Results: Intraabdominal pressure was measured twice daily via the bladder. Data recorded on admission were the patient demographics with Simplified Acute Physiology Score II, Acute Physiology and Chronic Health Evaluation II score, and type of admission; during intensive care stay, Sepsis-Related Organ Failure Assessment score and intraabdominal pressure were measured daily together with fluid balance. Nonsurvivors had a significantly higher mean intraabdominal pressure on admission than survivors: 11.4 4.8 vs. 9.5 4.8 mm Hg. Independent predictors for mortality were age (odds ratio, 1.04; 95% confidence interval, 1.01‐1.06; p .003), Acute Physiology and Chronic Health Evaluation II score (odds ratio, 1.1; 95% confidence interval, 1.05‐1.15; p < .0001), type of intensive care unit admission (odds ratio, 2.5 medical vs. surgical; 95% confidence interval, 1.24‐5.16; p .01), and the presence of liver dysfunction (odds ratio, 2.5; 95% confidence interval, 1.06‐5.8; p .04). The occurrence of intraabdominal hypertension during the intensive care unit stay was also an independent predictor of mortality (relative risk, 1.85; 95% confidence interval, 1.12‐3.06; p .01). Patients with intraabdominal hypertension at admission had significantly higher Sepsis-Related Organ Failure Assessment scores during the intensive care unit stay than patients without intraabdominal hypertension. Conclusions: Intraabdominal hypertension on admission was associated with severe organ dysfunction during the intensive care unit stay. The mean intraabdominal pressure on admission was not an independent risk factor for mortality; however, the occurrence of intraabdominal hypertension during the intensive care unit stay was an independent outcome predictor. (Crit Care Med 2005; 33:315‐322) |
| Databáze: | OpenAIRE |
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