KMID : 1144620190320020086
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Journal of Trauma and Injury 2019 Volume.32 No. 2 p.86 ~ p.92
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Clinical Effects of Intra-Abdominal Pressure in Critically Ill Trauma Patients
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Ryu Dong-Yeon
Kim Ho-Hyun Seok June-Pill Lee Chan-Kyu Yeo Kwang-Hee Choi Seon-Uoo Kim Jae-Hun Cho Hyun-Min
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Abstract
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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 ¡Ã12 mmHg. Abdominal compartment syndrome was defined as IAP ¡Ã20 mmHg plus ¡Ã1 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 ¡Ã20 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 ¡Ã20 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.
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KEYWORD
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Intra-abdominal hypertension, Critical care, Wounds and injuries, Pressure
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