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Ts08 prospective validation of the independent predictors for postinjury intra-abdominal hypertension.
MedLine Citation:
PMID:  17490374     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Purpose Prospective validation of recently established independent predictors for postinjury abdominal compartment syndrome (ACS) was performed. Methodology All trauma patients who met inclusion criteria (ICU admission, ISS > 15, Base Deficit (BD) > 5, or resuscitation with >5 L crystalloids) were prospectively monitored. Patients with isolated head injuries were excluded. Demographics, ISS, resuscitation fluids, physiological parameters, intra-abdominal pressure (IAP) and the independent predictors in two time windows "ED discharge"[SBP, crystalloids, Time-to OR, transfusions] and "ICU admission"[crystalloids, urine output (UO), Hb, Temperature, BD] were collected. Data are presented as mean +/- SEM, p < 0.05 considered significant. Results Twenty-two blunt trauma patients were monitored (Age 39 +/- 5 years, 77% males, ISS 32 +/- 2, SBP 107 +/- 5 mmHg, BD 7 +/- 1). No patients developed ACS. Seven patients developed IAH (IAP > 20 mmHg). IAH and non-IAH patients had the same age (41 +/- 7 vs 37 +/- 5 yrs) and admission BD (7.5 +/- 1.3 vs 6.3 +/- 1.2). IAH patients had higher ISS than non-IAH patients (39 +/- 3 vs 30 +/- 2). Outcomes (IAH vs non-IAH): ICU LOS (39 +/- 3 vs 30 +/- 2), Mortality (0% vs 7%), MOF (29% vs 0%). "ED-discharge predictors": The IAH and non-IAH patients had similar admission SBP, ED crystalloid volume, transfusions and ED time. "ICU-admission predictors": IAH and non-IAH patients had similar UO, crystalloid infusions, BD, temperature but the IAH group had lower Hb (99 +/- 5 vs 111 +/- 3 g/dl) than the non-IAH patients. Conclusions The incidence of ACS decreased from 14% to 0% in a comparable population. The predictors for ACS did not predict IAH. After the elimination of the lethal ACS, the clinical importance of postinjury IAH has to be defined.
Authors:
K J P Vans Wessem; P J Mackay; Z Balogh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  ANZ journal of surgery     Volume:  77 Suppl 1     ISSN:  1445-1433     ISO Abbreviation:  -     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101086634     Medline TA:  ANZ J Surg     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  A94     Citation Subset:  IM    
Affiliation:
John Hunter Hospital, Newcastle, New South Wales, Australia.
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