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Risk factors for intra-abdominal hypertension and abdominal compartment syndrome in patients admitted to the ICU

Introduction

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) as well as their risk factors were defined recently by consensus. These diseases have a high incidence and morbi-mortality in patients admitted to the ICU and represent a huge problem among critically ill patients.

Objective

To determine the incidence of IAH or ACS in patients admitted to a university hospital ICU with two or more risk factors.

Methods

All patients admitted to the ICU were evaluated daily. Those with at least two risk factors were submitted to intraabdominal pressure (IAP) monitoring by intravesical pressure method once daily, during 7 days or until death or ICU discharge. In each measure, the abdominal perfusion pressure (APP) (that is, IAP - mean arterial pressure) was recorded. Demographic data, APACHE II, ICU and hospital length of stay and mortality were determined. Results are presented as the percentage or mean ± standard deviation (Table 1).

Table 1 Characteristics of the study participants and mortality

Results

Patients were assessed from February 2010 to October 2010 and 164 were enrolled. Thirty-two patients fulfilled criteria for IAP monitoring (mean age 62 ± 17 years, 37% (12) female, mean APACHE II score 18 ± 4). Among these 32 patients, 62% (20) had at least one IAH episode and 12.5% (four) developed ACS. Only patients with ACS had APP <60 mmHg. Hospital LOS was 60 ± 55 days, ICU LOS was 14 ± 15 days. The 28-day, ICU and hospital mortalities were 31% (10), 38% (20) and 62% (20), respectively.

Conclusion

Risk factors have a high incidence in our ICU. IAH/ACS patients present a high mortality and a long LOS.

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Correspondence to M Assunção.

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Assunção, M., Oliveira, F., Mazza, B. et al. Risk factors for intra-abdominal hypertension and abdominal compartment syndrome in patients admitted to the ICU. Crit Care 15, P66 (2011). https://doi.org/10.1186/cc10214

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Keywords

  • High Mortality
  • Arterial Pressure
  • Emergency Medicine
  • Demographic Data
  • Hospital Mortality