Busani S, Soccorsi M C, Poma C, Girardis M
Cattedra e Divisione di Anestesiologia e Rianimazione, Università degli Studi di Modena e Reggio Emilia e Policlinico di Modena, Modena, Italy.
Transplant Proc. 2006 Apr;38(3):836-7. doi: 10.1016/j.transproceed.2006.01.076.
Intra-abdominal hypertension (IAH) is recognized to be associated with adverse outcomes in critically ill patients. Etiologic factors for IAH can be divided into three categories: medical, posttraumatic, and surgical/postoperative. No studies have been performed on patients who underwent nonelective surgery, so our aim was to determine prospectively the incidence of IAH among these patients during their intensive care stay to correlate intra-abdominal pressure (IAP) and other parameters. Abdominal pressure was recorded twice daily with the standard method. The study group enrolled 22 patients who underwent an abdominal operation that met urgency criteria and with a postoperative intensive care unit (ICU) stay of at least 48 hours. Several serum and clinical parameters were studied for the first 5 postoperative days as well as during ICU and hospital stay as well as monitored hospital mortality. Our results demonstrated that mortality was definitely higher among patients who developed IAH compared with non-IAH patients. Our results highlighted that a strong correlation existed between increasing values of IAP and worsening serum creatinine and PaO2/FiO2 quotient among patients who underwent nonelective surgery.
腹内高压（IAH）被认为与危重症患者的不良预后相关。IAH的病因可分为三类：内科、创伤后和外科/术后。尚未对接受非择期手术的患者进行研究，因此我们的目的是前瞻性地确定这些患者在重症监护期间IAH的发生率，以关联腹内压（IAP）和其他参数。采用标准方法每天记录两次腹压。研究组纳入了22例接受腹部手术且符合紧急标准、术后在重症监护病房（ICU）至少停留48小时的患者。在术后的前5天以及ICU和住院期间研究了多项血清和临床参数，并监测了住院死亡率。我们的结果表明，发生IAH的患者死亡率明显高于未发生IAH的患者。我们的结果突出显示，在接受非择期手术的患者中，IAP值升高与血清肌酐恶化以及PaO2/FiO2比值之间存在密切关联。
