Lonardo M, Piazza O, De Marco G, De Robertis E, Servillo G, Tufano R
Department of Surgical Sciences, Anesthesiology and Critical Care, University Federico II, Naples, Italy.
Minerva Anestesiol. 2007 Sep;73(9):447-50.
The aim of this study was to assess the prevalence of intra-abdominal hypertension and its prognostic value in critical patients.
In an observational study, 56 patients of a multidisciplinary intensive care unit (ICU) of a university hospital, with either surgical (44.6%) or medical (55.4%) diagnoses, were studied. Intra-abdominal pressure was quantified daily by bladder pressure method from the first to the eighth day of hospitalization.
The mean intra-abdominal pressure at admission was 9.97+/-5.26 mmHg; 41% of patients suffered moderate intra-abdominal hypertension (defined as intra-abdominal pressure greater than 11 mmHg) at admission. On day 1 mean intra-abdominal pressure was not significantly different between the patients who died and those who survived (9.69+/-5.06 mmHg vs 10.12+/-5.57 mmHg respectively), but by measuring IAP until day 8 it was possible to distinguish a subgroup of patients who showed a persistently elevated intra-abdominal pressure, developed further complications, later died (12.5+/-4.37 mmHg vs 7.17+/-2.02 mmHg, P=0.022).
Intra-abdominal pressure does not have prognostic value at ICU admission, but may predict bad outcomes later during the ICU stay. Intra-abdominal hypertension is a frequent and rarely recognized event in the ICU which can be monitored by the bladder pressure method throughout the period of hospitalization.
本研究旨在评估危重症患者腹腔内高压的发生率及其预后价值。
在一项观察性研究中，对某大学医院多学科重症监护病房（ICU）的56例患者进行了研究，这些患者的诊断包括外科疾病（44.6%）或内科疾病（55.4%）。从住院第一天到第八天，每天通过膀胱压力法对腹腔内压力进行量化。
入院时腹腔内平均压力为9.97±5.26 mmHg；41%的患者入院时患有中度腹腔内高压（定义为腹腔内压力大于11 mmHg）。在第1天，死亡患者和存活患者的腹腔内平均压力无显著差异（分别为9.69±5.06 mmHg和10.12±5.57 mmHg），但通过测量直至第8天的腹腔内压力，可以区分出一组腹腔内压力持续升高、出现更多并发症并随后死亡的患者亚组（12.5±4.37 mmHg对7.17±2.02 mmHg，P = 0.022）。
腹腔内压力在ICU入院时无预后价值，但可能预测ICU住院后期的不良结局。腹腔内高压在ICU中是一种常见但很少被认识到的情况，在整个住院期间可通过膀胱压力法进行监测。
