Intra-abdominal hypertension and hypoxic respiratory failure together predict adverse outcome - A sub-analysis of a prospective cohort
Por:
Regli, A, Blaser, A, De Keulenaer, B, Starkopf, J, Kimball, E, Malbrain, M, Van Heerden, P, Davis, W, Palermo, A, Dabrowski, W, Siwicka-Gieroba, D, Barud, M, Grigoras, I, Ristescu, A, Blejusca, A, Tamme, K, Maddison, L, Kirsimagi, U, Litvin, A, Kazlova, A, Filatau, A, Pracca, F, Sosa, G, Dos Santos, M, Kirov, M, Smetkin, A, Ilyina, Y, Gilsdorf, D, Ordonez, C, Caicedo, Y, Greiffenstein, P, Morgan, M, Bodnar, Z, Tidrenczel, E, Oliveira, G, Albuquerque, A, Pereira, B and IROI Study Investigators
Publicada:
1 ago 2021
Ahead of Print:
1 abr 2021
Categoría:
Critical care and intensive care medicine
Resumen:
Purpose: To assess whether the combination of intra-abdominal hypertension (IAH, intra-abdominal pressure >_ 12 mmHg) and hypoxic respiratory failure (HRF, PaO2/FiO2 ratio < 300 mmHg) in patients receiving invasive ventilation is an independent risk factor for 90-and 28-day mortality as well as ICU-and ventilation-free days. Methods: Mechanically ventilated patients who had blood gas analyses performed and intra-abdominal pressure measured, were included from a prospective cohort. Subgroups were defined by the absence (Group 1) or the presence of either IAH (Group 2) or HRF (Group 3) or both (Group 4). Mixed-effects regression analysis was performed. Results: Ninety-day mortality increased from 16% (Group 1, n = 50) to 30% (Group 2, n = 20) and 27% (Group 3, n = 100) to 49% (Group 4, n = 142), log-rank test p < 0.001. The combination of IAH and HRF was associated with increased 90-and 28-day mortality as well as with fewer ICU-and ventilation-free days. The association with 90-day mortality was no longer present after adjustment for independent variables. However, the association with 28-day mortality, ICU-and ventilation-free days persisted after adjusting for independent variables. Conclusions: In our sub-analysis, the combination of IAH and HRF was not independently associated with 90-day mortality but independently increased the odds of 28-day mortality, and reduced the number of ICU-and ventilation-free days. (c) 2021 Elsevier Inc. All rights reserved.
Filiaciones:
Regli, A:
Notre Dame Univ, Sch Med, Fremantle, WA, Australia
Univ Western Australia, Sch Med, Perth, WA, Australia
Blaser, A:
Univ Tartu, Dept Anaesthesiol & Intens Care, Tartu, Estonia
Lucerne Cantonal Hosp, Dept Intens Care Med, Luzern, Switzerland
De Keulenaer, B:
Univ Western Australia, Sch Surg, Perth, WA, Australia
Starkopf, J:
Univ Tartu, Dept Anaesthesiol & Intens Care, Tartu, Estonia
Tartu Univ Hosp, Dept Anaesthesiol & Intens Care, Tartu, Estonia
Kimball, E:
Univ Utah Sch Med, Dept Surg, Salt Lake City, UT USA
Malbrain, M:
Vrije Univ Brussel, Fac Engn, Dept Elect & Informat, Brussels, Belgium
Int Fluid Acad, Lovenjoel, Belgium
Van Heerden, P:
Hadassah Hebrew Univ Hosp, Gen Intens Care Unit, Jerusalem, Israel
Davis, W:
Univ Western Australia, Sch Med, Perth, WA, Australia
Palermo, A:
Fiona Stanley Hosp, Dept Intens Care, Perth, WA, Australia
Dabrowski, W:
Med Univ Lublin, Dept Anaesthesiol & Intens Care 1, Lublin, Poland
Siwicka-Gieroba, D:
Med Univ Lublin, Dept Anaesthesiol & Intens Care 1, Lublin, Poland
Barud, M:
Med Univ Lublin, Dept Anaesthesiol & Intens Care 1, Lublin, Poland
Grigoras, I:
Univ Med & Pharm, Grigore T Popa, Iasi, Romania
Reg Inst Oncol, Iasi, Romania
Ristescu, A:
Univ Med & Pharm, Grigore T Popa, Iasi, Romania
Reg Inst Oncol, Iasi, Romania
Blejusca, A:
Reg Inst Oncol, Iasi, Romania
Tamme, K:
Univ Tartu, Dept Anaesthesiol & Intens Care, Tartu, Estonia
Maddison, L:
Tartu Univ Hosp, Dept Anaesthesiol & Intens Care, Tartu, Estonia
Kirsimagi, U:
Tartu Univ Hosp, Dept Surg, Tartu, Estonia
Litvin, A:
Immanuel Kant Balt Fed Univ, Reg Clin Hosp, Dept Surg Disciplines, Kaliningrad, Russia
Kazlova, A:
Reg Clin Hosp, Dept Intens Care Med, Gomel, BELARUS
Filatau, A:
Reg Clin Hosp, Dept Intens Care Med, Gomel, BELARUS
Pracca, F:
Clin Univ Hosp, Dept Intens Care Unit, UDELAR, Montevideo, Uruguay
Sosa, G:
Clin Univ Hosp, Dept Intens Care Unit, UDELAR, Montevideo, Uruguay
Dos Santos, M:
Clin Univ Hosp, Dept Intens Care Unit, UDELAR, Montevideo, Uruguay
Kirov, M:
Northern State Med Univ, Dept Anesthesiol & Intens Care Med, Arkhangelsk, Russia
Smetkin, A:
Northern State Med Univ, Dept Anesthesiol & Intens Care Med, Arkhangelsk, Russia
Ilyina, Y:
Northern State Med Univ, Dept Anesthesiol & Intens Care Med, Arkhangelsk, Russia
Gilsdorf, D:
Univ Utah Sch Med, Dept Surg, Salt Lake City, UT USA
Ordonez, C:
Fdn Valle Lili Univ Valle, Dept Surg, Div Trauma & Acute Care Surg, Cali, Colombia
Caicedo, Y:
Fdn Valle Lili, Centro Invest Clin, Cali, Colombia
Greiffenstein, P:
Louisiana State Univ Hlth Sci Ctr, New Orleans, LA USA
Morgan, M:
Louisiana State Univ Hlth Sci Ctr, New Orleans, LA USA
UC Hlth Mem Hosp Cent, Colorado Springs, CO USA
:
Univ Hosp Torrevieja, Torrevieja, Spain
Letterkenny Univ Hosp, Letterkenny, Ireland
:
Univ Hosp Torrevieja, Torrevieja, Spain
Killybegs Family Hlth Ctr, Killybegs, Ireland
Oliveira, G:
Hosp Ctr Tondela Viseu, Polyvalent Intens Care Unit, Tondela Viseu, Portugal
Albuquerque, A:
Hosp Ctr Tondela Viseu, Polyvalent Intens Care Unit, Tondela Viseu, Portugal
Pereira, B:
Vassouras Univ, Masters Program Hlth Appl Sci, Postgrad & Res Div, Vassouras, RJ, Brazil
Grupo Surg, Campinas, SP, Brazil
Terzius Inst Educ, Campinas, SP, Brazil
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