Prevalence of intra-abdominal hypertension in critically ill patients: a multicentre epidemiological study
Prevalence of intra-abdominal hypertension in critically ill patients: a multicentre epidemiological study
复制标题
DOI：
10.1007/s00134-004-2169-9
复制
发表时间：
2004-05-01
影响因子：
38.9
通讯作者：
Gattinoni, L
中科院分区：
文献类型：
--
作者：
Malbrain, MLNG;Chiumello, D;Gattinoni, L
客观的。尽管腹内高压（IAH）可导致多个器官功能障碍并提高死亡率，但有关危重患者腹内高压的发病率和危险因素的信息很少。本研究评估了重症监护患者混合人群中 IAH 的患病率及其危险因素。设计。在 6 个国家的 13 个 ICU 中进行的一项多中心、前瞻性 1 天点患病率流行病学研究。干预措施。没有任何。患者。在为期 1 天的研究期间，有 97 名患者入住其中一间 ICU 超过 24 小时。方法。通过膀胱压力法测量腹内压（IAP）四次（每6小时）。数据包括人口统计学、入院医疗或手术类型、SOFA评分、病因因素（如腹部手术、腹腔积血、腹部感染、大量液体复苏和肠梗阻）以及诱发因素（如体温过低、酸中毒、多次输血、凝血病、败血症、肝功能障碍、肺炎和菌血症）。结果。我们招募了 97 名患者，平均年龄 64+/-15 岁，其中 57 名 (59%) 因内科住院和 40 名 (41%) 因手术入院，SOFA 评分为 6.5+/-4.0。平均 IAP 为 9.8+/-4.7 mmHg。 IAH（定义为 IAP 12 mmHg 或以上）的患病率为 50.5%，8.2% 患有腹腔间隔室综合征（定义为 IAP 20 mmHg 或以上）。与 IAH 显着相关的唯一危险因素是体重指数，而大量液体复苏、肾脏和凝血功能障碍的显着性有限。结论。尽管我们发现 IAH 的患病率相当高，但没有可靠的危险因素与 IAH 相关；因此，为了获得有关 IAH 的有效信息，需要测量 IAP。
Objective. Although intra-abdominal hypertension (IAH) can cause dysfunction of several organs and raise mortality, little information is available on the incidence and risk factors for IAH in critically ill patients. This study assessed the prevalence of IAH and its risk factors in a mixed population of intensive care patients. Design. A multicentre, prospective 1-day point-prevalence epidemiological study conducted in 13 ICUs of six countries. Interventions. None. Patients. Ninety-seven patients admitted for more than 24 h to one of the ICUs during the 1-day study period. Methods. Intra-abdominal pressure (IAP) was measured four times (every 6 h) by the bladder pressure method. Data included the demographics, medical or surgical type of admission, SOFA score, etiological factors such as abdominal surgery, haemoperitoneum, abdominal infection, massive fluid resuscitation, and ileus and predisposing conditions such as hypothermia, acidosis, polytransfusion, coagulopathy, sepsis, liver dysfunction, pneumonia and bacteraemia. Results. We enrolled 97 patients, mean age 64+/-15 years, 57 (59%) medical and 40 (41%) surgical admission, SOFA score of 6.5+/-4.0. Mean IAP was 9.8+/-4.7 mmHg. The prevalence of IAH (defined as IAP 12 mmHg or more) was 50.5 and 8.2% had abdominal compartment syndrome (defined as IAP 20 mmHg or more). The only risk factor significantly associated with IAH was the body mass index, while massive fluid resuscitation, renal and coagulation impairment were at limit of significance. Conclusion. Although we found a quite high prevalence of IAH, no risk factors were reliably associated with IAH; consequently, to get valid information about IAH, IAP needs to be measured.