| Primary and secondary intra-abdominal hypertension--different impact on ICU outcome. | |
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MedLine Citation:
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PMID: 18446319 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Annika Reintam; Pille Parm; Reet Kitus; Hartmut Kern; Joel Starkopf |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-05-01 |
Journal Detail:
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Title: Intensive care medicine Volume: 34 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2008 Sep |
Date Detail:
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Created Date: 2008-08-18 Completed Date: 2009-01-08 Revised Date: 2009-08-19 |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1624-31 Citation Subset: IM |
Affiliation:
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Clinic of Anaesthesiology and Intensive Care, University of Tartu, Puusepa 8, 51014, Tartu, Estonia. annika.reintam@itk.ee |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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