Document Detail


Primary and secondary intra-abdominal hypertension--different impact on ICU outcome.
MedLine Citation:
PMID:  18446319     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the differences in incidence, time course and outcome of primary versus secondary intra-abdominal hypertension (IAH), and to evaluate IAH as an independent risk factor of mortality in a presumable risk population of critically ill patients. DESIGN: Prospective observational study. SETTING: General intensive care unit of a university hospital. PATIENTS: A total of 257 mechanically ventilated patients at presumable risk for the development of IAH were studied during their ICU stay and followed up for 90-day survival. INTERVENTIONS: Repeated measurements of intra-abdominal pressure (IAP). MEASUREMENTS AND RESULTS: IAP was measured intermittently, via bladder. IAH (sustained or repeated IAP > or = 12 mmHg) developed in 95 patients (37.0%). Primary IAH was observed in 60 and secondary IAH in 35 patients. Patients with secondary IAH demonstrated a significant increase of mean IAP during the first three days (mean DeltaIAP was 2.2 +/- 4.7 mmHg), whilst IAP decreased (mean DeltaIAP -1.1 +/- 3.7 mmHg) in the patients with primary IAH. The patients with IAH had a significantly higher ICU- (37.9 vs. 19.1%; P = 0.001), 28-day (48.4 vs. 27.8%, P = 0.001), and 90-day mortality (53.7 vs. 35.8%, P = 0.004) compared to the patients without the syndrome. Patients with secondary IAH had a significantly higher ICU mortality than patients with primary IAH (P = 0.032). Development of IAH was identified as an independent risk factor for death (OR 2.52; 95% CI 1.23-5.14). CONCLUSIONS: Secondary IAH is less frequent, has a different time course and worse outcome than primary IAH. Development of IAH during ICU period is an independent risk factor for death.
Authors:
Annika Reintam; Pille Parm; Reet Kitus; Hartmut Kern; Joel Starkopf
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-05-01
Journal Detail:
Title:  Intensive care medicine     Volume:  34     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-18     Completed Date:  2009-01-08     Revised Date:  2009-08-19    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1624-31     Citation Subset:  IM    
Affiliation:
Clinic of Anaesthesiology and Intensive Care, University of Tartu, Puusepa 8, 51014, Tartu, Estonia. annika.reintam@itk.ee
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MeSH Terms
Descriptor/Qualifier:
Abdomen*
Compartment Syndromes / classification,  etiology,  physiopathology*
Female
Hospital Mortality*
Humans
Hypertension / classification,  etiology*,  physiopathology*
Intensive Care Units
Length of Stay
Male
Middle Aged
Pressure
Prospective Studies
ROC Curve
Respiration, Artificial / adverse effects
Risk Factors
Severity of Illness Index
Comments/Corrections
Comment In:
Intensive Care Med. 2009 Sep;35(9):1650   [PMID:  19526216 ]
Intensive Care Med. 2008 Sep;34(9):1565-9   [PMID:  18446318 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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