Ghulam Murtaza1, K M Inam Pal2, Mohammad Raheel Nawaz Jajja3, Zunaira Nawaz4, Reham Koondhar5, Sana Nasim6. 1. Patel Hospital, Gulshan-Iqbal, Karachi, Pakistan. Electronic address: gms786@gmail.com. 2. The Aga Khan University Hospital, Karachi, Pakistan. Electronic address: inam.pal@aku.edu. 3. Department of Surgery, Emory University, Atlanta, GA 30322, United States. Electronic address: raheeljajja@gmail.com. 4. The Aga Khan University Hospital, Karachi, Pakistan. 5. The Aga Khan University Hospital, Karachi, Pakistan. Electronic address: reham.koondhar@aku.edu. 6. The Aga Khan University Hospital, Karachi, Pakistan. Electronic address: sana.nasim@aku.edu.
Abstract
BACKGROUND: This study was conducted primarily to determine the prevalence and incidence of intra-abdominal hypertension (IAH) in a mixed ICU (medical & surgical) population and, secondarily, to compare outcomes between patients with and without IAH. METHODS: The prospective cohort study was conducted from April to July 2011 on adult patients admitted in ICU, on mechanical ventilation and with an indwelling urinary catheter. Intra-vesicular pressure was measured. Primary endpoint was IAH and it was defined as Intra-abdominal pressure>12 mm Hg on two consecutive readings 6 h apart. RESULTS: Total 83 patients were enrolled in the study; 61% from medical services and 39% from surgical services. Mean age in years±SD was 47 ± 17.5 with male preponderance (66%). IAH was detected in 23/83 (28%) at the time of admission, while six out of remaining 60 patients (10%) developed the condition during their ICU stay; the incidence and prevalence was 10% and 35%, respectively. Secondary end points of the study comparing outcomes between patients with and without IAH, though different in the two groups, did not achieve statistical significance. In-hospital mortality 65.5% vs. 44.4% p-value 0.054. New onset renal failure 34.5% vs. 16.7% p-value 0.054%. Difficulty in weaning from mechanical ventilation 37.9% vs. 25.9% p-value 0.008. CONCLUSION: IAH is a poorly recognized clinical entity with potentially devastating impact on patient outcomes. Since majority of patients had IAH at the time of admission, all ICU patients especially on ventilator should have baseline intra-abdominal pressures measured at the time of admission and subjected to appropriate management to prevent them from developing abdominal compartment syndrome.
BACKGROUND: This study was conducted primarily to determine the prevalence and incidence of intra-abdominal hypertension (IAH) in a mixed ICU (medical & surgical) population and, secondarily, to compare outcomes between patients with and without IAH. METHODS: The prospective cohort study was conducted from April to July 2011 on adult patients admitted in ICU, on mechanical ventilation and with an indwelling urinary catheter. Intra-vesicular pressure was measured. Primary endpoint was IAH and it was defined as Intra-abdominal pressure>12 mm Hg on two consecutive readings 6 h apart. RESULTS: Total 83 patients were enrolled in the study; 61% from medical services and 39% from surgical services. Mean age in years±SD was 47 ± 17.5 with male preponderance (66%). IAH was detected in 23/83 (28%) at the time of admission, while six out of remaining 60 patients (10%) developed the condition during their ICU stay; the incidence and prevalence was 10% and 35%, respectively. Secondary end points of the study comparing outcomes between patients with and without IAH, though different in the two groups, did not achieve statistical significance. In-hospital mortality 65.5% vs. 44.4% p-value 0.054. New onset renal failure 34.5% vs. 16.7% p-value 0.054%. Difficulty in weaning from mechanical ventilation 37.9% vs. 25.9% p-value 0.008. CONCLUSION: IAH is a poorly recognized clinical entity with potentially devastating impact on patient outcomes. Since majority of patients had IAH at the time of admission, all ICU patients especially on ventilator should have baseline intra-abdominal pressures measured at the time of admission and subjected to appropriate management to prevent them from developing abdominal compartment syndrome.
Authors: Michaela Ramser; Philippe M Glauser; Tracy R Glass; Benjamin Weixler; Martin T R Grapow; Henry Hoffmann; Philipp Kirchhoff Journal: World J Surg Date: 2021-01-22 Impact factor: 3.352
Authors: M Luisa Bordejé; Juan C Montejo; M Lidón Mateu; Manuel Solera; Jose A Acosta; Mar Juan; Francisco García-Córdoba; Miguel A García-Martínez; Rosa Gastaldo Journal: Nutrients Date: 2019-11-01 Impact factor: 5.717