Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/340649
Type: Artigo
Title: Incidence, risk factors, and outcomes of intra-abdominal hypertension in critically ill patients : a prospective multicenter study (iroi study)
Author: Blaser, Annika Reintam
Regli, Adrian
De Keulenaer, Bart
Kimball, Edward J.
Starkopf, Liis
Davis, Wendy A.
Greiffenstein, Patrick
Starkopf, Joel
Palermo, Annamaria
Tamme, Kadri
Maddison, Liivi
Jakobson, Triin
Kirov, Mikhail
Smetkin, Alexey
Ilyina, Yana
Litvin, Andrey
Kazlova, Anastasiya
Filatov, Aliaksandr
Pracca, Francisco
Sosa, Gustavo
Dos Santos, Maicol
Grigoras, Ioana
Ristescu, Irina
Blejusca, Adina
Bodnar, Zsolt
Tidrenczel, Edit
Oliveira, Gina
Albuquerque, Ana
Fernandes, Manuela
Kirsimagi, Ulle
Ordonez, Carlos A.
Manzano-Nunez, Ramiro
Pereira, Bruno M.
Moore, Margaret M.
Dabrowski, Wojciech
Abstract: To identify the prevalence, risk factors, and outcomes of intra-abdominal hypertension in a mixed multicenter ICU population. Prospective observational study. Fifteen ICUs worldwide. Consecutive adult ICU patients with a bladder catheter. None. Four hundred ninety-one patients were included. Intra-abdominal pressure was measured a minimum of every 8 hours. Subjects with a mean intra-abdominal pressure equal to or greater than 12 mm Hg were defined as having intra-abdominal hypertension. Intra-abdominal hypertension was present in 34.0% of the patients on the day of ICU admission (159/467) and in 48.9% of the patients (240/491) during the observation period. The severity of intra-abdominal hypertension was as follows: grade I, 47.5%; grade II, 36.6%; grade III, 11.7%; and grade IV, 4.2%. The severity of intra-abdominal hypertension during the first 2 weeks of the ICU stay was identified as an independent predictor of 28-and 90-day mortality, whereas the presence of intra-abdominal hypertension on the day of ICU admission did not predict mortality. Body mass index, Acute Physiology and Chronic Health Evaluation II score greater than or equal to 18, presence of abdominal distension, absence of bowel sounds, and positive end-expiratory pressure greater than or equal to 7 cm H2O were independently associated with the development of intra-abdominal hypertension at any time during the observation period. In subjects without intra-abdominal hypertension on day 1, body mass index combined with daily positive fluid balance and positive end-expiratory pressure greater than or equal to 7 cm H2O (as documented on the day before intra-abdominal hypertension occurred) were-associated with the development of intraabdominal hypertension during the first week in the ICU. In our mixed ICU patient cohort, intra-abdominal hypertension occurred in almost half of all subjects and was twice as prevalent in mechanically ventilated patients as in spontaneously breathing patients. Presence and severity of intra-abdominal hypertension during the observation period significantly and independently increased 28-and 90-day mortality. Five admission day variables were independently associated with the presence or development of intra-abdominal hypertension. Positive fluid balance was associated with the development of intra-abdominal hypertension after day 1
Subject: Fatores de risco
Country: Estados Unidos
Editor: Lippincott Williams & Wilkins
Rights: Fechado
Identifier DOI: 10.1097/CCM.0000000000003623
Address: https://journals.lww.com/ccmjournal/Fulltext/2019/04000/Incidence,_Risk_Factors,_and_Outcomes_of.6.aspx
Date Issue: 2019
Appears in Collections:FCM - Artigos e Outros Documentos

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