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  • Title: [The monitoring of intra-abdominal pressure in critically ill patients].
    Author: Yi M, Yao G, Bai Y.
    Journal: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue; 2014 Mar; 26(3):175-8. PubMed ID: 24598291.
    Abstract:
    OBJECTIVE: To monitor intra-abdominal pressure (IAP) in critically ill patients. METHODS: A prospective cohort study was conducted. IAP was measured through the bladder technique. Patients were screened for intra-abdominal hypertension (IAH, IAP≥12 mmHg) upon ICU admission. The patients with IAH/abdominal compartment syndrome (ACS) were given appropriate treatment and management for IAH and/or ACS. Mean arterial pressure (MAP), IAP, abdominal perfusion pressure (APP), filtration gradient (FG) and serum creatinine (Cr) were determined in patients with or without IAH, as well as in survivors and non-survivors. RESULTS: The entire protocol of IAP measurement was completed in 88 patients. Number of IAH and ACS patients was 25 (28.4%) and 2 (2.3%), respectively. The number of survivors was 80 (90.9%), with 8 (9.1%) non-survivors. Compared with non-IAH patients, IAP and SCr were increased in IAH patients (IAP: 14.16±2.43 mmHg vs. 8.13±2.28 mmHg, t=10.984, P=0.000; SCr: 126.72±83.02 μmol/L vs. 73.41±37.59 μmol/L, t=3.087, P=0.005), with a lower FG (59.32±17.08 mmHg vs. 70.24±15.03 mmHg, t=-2.956, P=0.004). There were no significant differences in MAP and APP between IAH group and non-IAH group (MAP: 79.18±12.33 mmHg vs. 88.71±17.34 mmHg, t=-1.368,P=0.190; APP: 73.40±16.11 mmHg vs. 78.37±14.32 mmHg, t=-1.415, P=0.161). Compared with survivors, non-survivors showed significantly lower APP and FG (APP: 60.88±14.58 mmHg vs. 78.56±14.06 mmHg, t=3.382, P=0.001; FG: 50.38±16.18 mmHg vs. 68.81±15.44 mmHg, t=3.208, P=0.002), and higher SCr (129.12±83.62 μmol/L vs. 84.36±55.15 μmol/L, t=-2.082, P=0.040). There was no significant difference in IAP and MAP between survivors and non-survivors (MAP: 71.00±25.46 mmHg vs. 84.38±13.53 mmHg, t=1.224, P=0.238; IAP: 10.62±5.34 mmHg vs. 9.76±3.40 mmHg, t=-0.647, P=0.519). CONCLUSIONS: Earlier IAP measurements in critically ill patients are essential for the detection of IAH/ACS and renal injury. With appropriate management of IAH/ACS, significant decrease in morbidity and mortality of patients has been achieved.
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