J Korean Soc Traumatol.  2019 Jun;32(2):86-92. 10.20408/jti.2018.052.

Clinical Effects of Intra-Abdominal Pressure in Critically Ill Trauma Patients

Affiliations
  • 1Department of Trauma Surgery, Pusan National University Hospital, Busan, Korea. gskhh@naver.com
  • 2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
  • 3Department of Trauma Surgery, Wonkwang University Hospital, Iksan, Korea.
  • 4Department of Cardiovascular & Thoracic Surgery, Peruen Hospital, Changwon, Korea.

Abstract

PURPOSE
There is increasing interest in intra-abdominal pressure (IAP) and intra-abdominal hypertension (IAH) in critically ill patients. This study investigated the effects and outcomes of elevated IAP in a trauma intensive care unit (ICU) population.
METHODS
Eleven consecutive critically ill patients admitted to the trauma ICU at Pusan National University Hospital Regional Trauma Center were included in this study. IAP was measured every 8-12 hours (intermittently) for 72 hours. IAP was registered as mean and maximal values per day throughout the study period. IAH was defined as IAP ≥12 mmHg. Abdominal compartment syndrome was defined as IAP ≥20 mmHg plus ≥1 new organ failure. The main outcome measure was in-hospital mortality.
RESULTS
According to maximal and mean IAP values, 10 (90.9%) of the patients developed IAH during the study period. The Sequential Organ Failure Assessment (SOFA) score was significantly higher in patients with IAP ≥20 mmHg than in those with IAP <20 mmHg (16 vs. 5, p=0.049). The hospital mortality rate was 27.3%. Patients with a maximum IAP ≥20 mmHg exhibited significantly higher hospital mortality rates (p=0.006). Non-survivors had higher maximum and mean IAP values.
CONCLUSIONS
Our results suggest that an elevated IAP may be associated with a poor prognosis in critically ill trauma patients.

Keyword

Intra-abdominal hypertension; Critical care; Wounds and injuries; Pressure

MeSH Terms

Busan
Critical Care
Critical Illness*
Hospital Mortality
Humans
Intensive Care Units
Intra-Abdominal Hypertension
Outcome Assessment (Health Care)
Prognosis
Trauma Centers
Wounds and Injuries
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