Clinical Effects of Intra-Abdominal Pressure in Critically Ill Trauma Patients
Dong Yeon Ryu, M.D.1,2, Hohyun Kim, M.D.1,2, June Pill Seok, M.D.3, Chan Kyu Lee, M.D.1,2, Kwang-Hee Yeo, M.D.1,2, Seon-Uoo Choi, M.D.4, Jae-Hun Kim, M.D.1,2, Hyun Min Cho, M.D.1,2
1Department of Trauma Surgery, Pusan National University Hospital, Busan, Korea
2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
3Department of Trauma Surgery, Wonkwang University Hospital, Iksan, Korea
4Department of Cardiovascular & Thoracic Surgery, Peruen Hospital, Changwon, Korea
2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
3Department of Trauma Surgery, Wonkwang University Hospital, Iksan, Korea
4Department of Cardiovascular & Thoracic Surgery, Peruen Hospital, Changwon, Korea
Correspondence to: Hohyun Kim, M.D.
Department of Trauma Surgery, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seogu, Busan 49241, Korea
Tel: +82-51-240-7369
Fax: +82-51-240-7719
E-mail: gskhh@naver.com
Department of Trauma Surgery, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seogu, Busan 49241, Korea
Tel: +82-51-240-7369
Fax: +82-51-240-7719
E-mail: gskhh@naver.com
Received November 14, 2018; Revised December 24, 2018; Accepted January 4, 2019.
- Abstract
- 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 ≥12 mmHg. Abdominal compartment syndrome was defined as IAP ≥20 mmHg plus ≥1 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 ≥20 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 ≥20 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. - Keywords : Intra-abdominal hypertension; Critical care; Wounds and injuries; Pressure
- March 2020, 33 (1)
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