Daily intra‐abdominal pressure, Sequential Organ Failure Score and fluid balance predict duration of mechanical ventilation

Iyer, Dushyant; Hunt, Leanne; Frost, Steven A.; Åneman, Anders

doi:10.1111/aas.13211

Cited by 6 publications

(4 citation statements)

References 33 publications

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“…Hudorovic and Vicic-Hudorovic [19] found no significant difference in relation to the IAP values and disease severity scores. Nevertheless, Iyer et al [20] suggested that a nomogram integrating daily IAP, SOFA score, and fluid balance might be used to predict the duration of mechanical ventilation. The SOFA scores were not one of the endpoints of the current study.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with increased intra-abdominal pressure in patients undergoing cardiac surgery

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Yapıcı

et al. 2020

Turk Gogus Kalp Dama

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Bu çalışmada kalp cerrahisi yapılan hastalarda intraabdominal basınç değişiklikleri ve artmış intraabdominal basınç ile ilişkili risk faktörleri araştırıldı. Ça lış ma pla nı: Temmuz 2016 -Ocak 2017 tarihleri arasında kardiyopulmoner baypas ile kalp cerrahisi yapılan toplam 100 hasta (74 erkek, 26 kadın; ort. yaş 55.9±14.3 yıl; dağılım, 19-75 yıl) çalışmaya alındı. Hastaların demografik ve klinik özellikleri ve ameliyat sırası ve ameliyat sonrası verileri kaydedildi. İntraabdominal basınç, anestezi indüksiyonu sonrası, yoğun bakım ünitesine girişte ve ameliyat sonrası 12. ve 24. saatlerde üriner kateter ile ölçüldü. Hastalar intrabdominal basınca göre Grup 1 (≥12 mmHg; n=49) ve Grup 2 (<12 mmHg; n=51) olmak üzere iki gruba ayrıldı. Bul gu lar: Tek değişkenli regresyon analizinde yüksek intraabdominal basınç anestezi indüksiyonundan sonra ölçülen intraabdominal basınç (olasılık oranı= 0.70, p= 0.001), yaş (olasılık oranı= 0.95, p= 0.004), hipertansiyon (olasılık oranı=4.51, p= 0.0001), kardiyopulmoner baypas süresi (olasılık oranı= 0.97, p= 0.0001), ameliyat sırası laktat düzeyleri (olasılık oranı= 0.53, p= 0.0001), eritrosit kullanımı (olasılık oranı=0.24, p=0.0001), dopamin kullanımı (olasılık oranı=0.21, p=0.002), dobutamin (olasılık oranı= 0.28, p= 0.005), noradrenalin kullanımı (olasılık oranı= 0.25, p= 0.016), ameliyat sonrası laktat düzeyleri (olasılık oranı= 0.60, p= 0.0001), kros-klemp süresi (olasılık oranı= 0.97, p= 0.000), atriyal fibrilasyon (olasılık oranı=5.89, p= 0.004) ve akut böbrek hasarı (olasılık oranı=8.33, p= 0.048) ile ilişkili bulundu. Çok değişkenli analizde ise, başlangıç intraabdominal basınç (olasılık oranı= 0.70, p= 0.045), yaş (olasılık oranı= 0.93, p= 0.032), hipertansiyon (olasılık oranı=6.87, p= 0.023), kardiyopulmoner baypas süresi (olasılık oranı= 0.98, p= 0.062), ameliyat sırası laktat düzeyleri (olasılık oranı= 0.57, p= 0.035) ve eritrosit kullanımı (olasılık oranı= 0.19, p= 0.003) istatistiksel olarak anlamlı olmayı sürdürdü. So nuç: Çalışma sonuçlarımız kalp cerrahisi yapılan hastalarda yaş, hipertansiyon, kardiyopulmoner baypas süresi, ameliyat sırası laktat düzeyleri ve eritrosit kullanımının intraabdominal basınç yüksekliği ile ilişkili risk faktörleri olduğunu göstermektedir. Bu risk faktörlerinin bilinirliğinin artması ve intraabdominal basınç ölçümünün ameliyat sonrası değişken hemodinami, düşük kalp debisi ve yüksek laktat düzeyleri olan hastaların standart takip şemasına eklenmesi, komplikasyonların erken tanısı ve morbiditenin azaltılmasında yararlı olabilir.

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Section: Discussionmentioning

confidence: 99%

Factors associated with increased intra-abdominal pressure in patients undergoing cardiac surgery

Kılıç

Yapıcı

et al. 2020

Turk Gogus Kalp Dama

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“…For patients with ΔIAP ≥ 38mmHg, only 3 (5.1%) failed extubation, and none of the patients with ΔIAP greater than 50mmHg failed extubation. Studies [32][33][34] have shown that the abdominal muscles are an P r e p r i n t important component of the respiratory muscles. The strength of the respiratory muscles affects the outcome of extubation.…”

Section: Discussionmentioning

confidence: 99%

Intra-abdominal pressure for predicating extubation failure in mechanically ventilated patients: it does work

et al. 2021

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IntroductionReducing the extubation failure is vital to the early recovery of patients with mechanical ventilation(MV). We aimed to explore the predictive value of the change of intra-abdominal pressure(ΔIAP) before extubation on the extubation failure in MV patients.Material and methodsPatients undergone MV for more than 24 hours were selected. We used a urodynamic monitor to measure ΔIAP 30 minutes before extubation. The characteristics and prognosis of MV patients were analyzed. Receiver operating characteristic(ROC) curve was drawn to analyze the predictive value of ΔIAP for extubation failure.ResultsA total of 173 MV patients were included. The risks of extubation failure increased with the decrease of ΔIAP. The risk of extubation failure in ΔIAP≤21mmHg group was 5.7 times that of the ΔIAP≥38mmHg group (OR 5.7, 95%CI 1.5-22.0), the risk of extubation failure in ΔIAP 22～37 mmHg group was 3.8 times that of the ΔIAP≥38mmHg group (OR 3.8, 95%CI 1.0-15.3). The area under the curve (AUC) predicted by ΔIAP for extubation failure was 0.721, the cutoff value was 31mmHg with 82.8% sensitivity and 48.6% specificity. There were no significant differences in the duration of MV, length of ICU stay, and death in ICU of the three groups of patients (all P>0.05).ConclusionsThe ΔIAP has good reference value for predicting extubation failure, which is negatively correlated with the risk of extubation failure in patients with MV. For MV patients with ΔIAP≤31mmHg, they may have higher risk of extubation failure, early alert and interventions are highlighted for those patients.

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“…The exclusion criteria were as follows: age ≤28 days (n = 82) or >14 years (n = 21), PICU admission for <24 h (n = 47), lack of parental consent (n = 6), use of chemical neuromuscular blockade (n = 15), and history of neurogenic bladder (n = 9) or bladder surgery (n = 28). Finally, 229 critically ill children were enrolled in the study, and the mortality predictive value was determined in these patients; 111 of the 229 patients did not have high-risk factors (Supplementary Table 1) (with the exception of physiological parameters) or clinical manifestations of IAH (9), and the normal IAP values were determined in these patients. The study protocol was approved by the Ethics Committees of the two study centers (2013, No.…”

Section: Methodsmentioning

confidence: 99%

“…Moreover, only few studies have examined the normal reference range of IAP in PICU patients (7,8). According to the updated World Society of the Abdominal Compartment Syndrome (WSACS) guidelines (9), the normal IAP value in a critically ill child was 4-10 mmHg; IAH was defined as a sustained IAP elevation of >10 mmHg; the guidelines are based on data collected from a single-center study of children who were put on mechanical ventilation (MV) (7). However, a recent study identified MV as a risk factor for IAH; additionally, a positive end-expiratory pressure (PEEP) level of >10 cmH 2 O (1 cmH 2 O = 0.098 kPa) is considered a risk factor for IAH in children (10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Intra-abdominal Pressure Has a Good Predictive Power for 28-Day Mortality: A Prospective Observational Study Conducted in Critically Ill Children

Liang

Shen

et al. 2020

Front. Pediatr.

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Objective: Elevated intra-abdominal pressure (IAP) is associated with organ dysfunction in critically ill children. Thus far, the predictive value of IAP for mortality remains unknown. Moreover, only few studies determined normal IAP values in pediatric intensive care unit (PICU) children. This study aimed to determine the predictive value of IAP for mortality and calculate normal IAP values in PICU patients.Liang et al. Intra-abdominal Pressure in PICU PatientsConclusions: IAP has good predictive power for 28-day mortality. The optimal IAP cutoff point is 12.13 mmHg. The IAP reference range is 2.0-13.2 mmHg, which was not associated with factors such as sex, age, weight, and BMI in PICU children. We recommend that IAP be included in critical illness scoring systems in the future. IAP >12.13 mmHg may be more suitable for IAH definition in PICU patients.

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Daily intra‐abdominal pressure, Sequential Organ Failure Score and fluid balance predict duration of mechanical ventilation

Abstract: IAPs did not correlate with pulmonary compliance in critically ill patients. Increased IAP was associated with a longer duration of mechanical ventilation. A nomogram integrating daily IAP, SOFA score and fluid balance may be used to predict the duration of mechanical ventilation.

Cited by 6 publications

References 33 publications

Factors associated with increased intra-abdominal pressure in patients undergoing cardiac surgery

Factors associated with increased intra-abdominal pressure in patients undergoing cardiac surgery

Intra-abdominal pressure for predicating extubation failure in mechanically ventilated patients: it does work

Intra-abdominal Pressure Has a Good Predictive Power for 28-Day Mortality: A Prospective Observational Study Conducted in Critically Ill Children

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