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. 2015 May 30:10:22.
doi: 10.1186/s13017-015-0016-7. eCollection 2015.

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

Kyu-Hyouck Kyoung  1 , Suk-Kyung Hong  2
Affiliations

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

Kyu-Hyouck Kyoung et al. World J Emerg Surg. .

Abstract

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.

Trial registration: NCT01784458.

Keywords: Enteral feeding, abdominal perfusion pressure; Intra-abdominal hypertension; Intra-abdominal pressure; Severe sepsis.

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Figures

Fig. 1
Fig. 1
Distribution of patients by duration of intra-abdominal hypertension
Fig. 2
Fig. 2
Clinical course according to duration of intra-abdominal hypertension. Correlation between duration of intra-abdominal hypertension and a length of intensive care unit stay, b duration of ventilatory support, c duration of renal replacement therapy, d initiation of enteral feeding. Two patients with chronic renal failure on hemodialysis were excluded on Fig. 2c. Two patients who did not try enteral feeding were excluded on Fig. 2d
See this image and copyright information in PMC

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