Intra‐abdominal Pressure as a Prognostic Factor for Tolerance of Enteral Nutrition in Critical Patients

Bejarano, Natalia; Navarro, Salvador; Rebasa, Pere; Garcia-Esquirol, Oscar; Hermoso, Judit

doi:10.1177/0148607112464238

Cited by 20 publications

(23 citation statements)

References 23 publications

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“…The authors proposed an interesting combination of IAP and APACHE II score in order to predict FI. Indeed, the results suggest that patients with higher APACHE II scores are more vulnerable to IAP induced FI [114]. In many other studies, higher severity of illness scores have been reported in patients with IAH, as well as in patients with GI dysfunction and FI [4,19,20].…”

Section: Studies Connecting Iap and Clinical Symptoms Of Gi Dysfunctionmentioning

confidence: 70%

“…A higher prevalence of feeding intolerance (FI) in patients with IAH has been demonstrated in several studies [4,114]. Bejarano et al [114] showed that baseline IAP together with an APACHE II score may predict FI.…”

Section: Studies Connecting Iap and Clinical Symptoms Of Gi Dysfunctionmentioning

confidence: 99%

“…Bejarano et al [114] showed that baseline IAP together with an APACHE II score may predict FI. The authors proposed an interesting combination of IAP and APACHE II score in order to predict FI.…”

Section: Studies Connecting Iap and Clinical Symptoms Of Gi Dysfunctionmentioning

confidence: 99%

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Abdominal pressure and gastrointestinal function: an inseparable couple?

Blaser¹,

Malbrain²,

Regli³

2017

Anaesthesiol Intensive Ther

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Evaluating the degree of organ dysfunction is a cornerstone in distinguishing patients with critical illness from those without. However, evaluation of the gastrointestinal function in critically ill patients is not unified, and is still largely based on subjective clinical evaluation. Although intra-abdominal pressure has been proposed as a parameter to facilitate monitoring of abdominal compartment in critical illness, the interactions between intra-abdominal pressure and gastrointestinal function are poorly clarified. The aim of this current review is to describe interactions and associations between gastrointestinal dysfunction and intra-abdominal pressure from a pathophysiological and clinical point of view.

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Section: Studies Connecting Iap and Clinical Symptoms Of Gi Dysfunctionmentioning

confidence: 70%

Section: Studies Connecting Iap and Clinical Symptoms Of Gi Dysfunctionmentioning

confidence: 99%

See 1 more Smart Citation

Abdominal pressure and gastrointestinal function: an inseparable couple?

Blaser¹,

Malbrain²,

Regli³

2017

Anaesthesiol Intensive Ther

View full text Add to dashboard Cite

show abstract

“…Bejarano et al [30] assessed the relationship between baseline IAP (before starting EN) and EN tolerance. According to their findings, APACHE II scores combined with IAP served to predict a patient’s EN tolerance.…”

Section: Discussionmentioning

confidence: 99%

“…Also, the criteria for intolerance were not the same. In the study by Bejarano et al [30] a GRV > 200 mL was already considered as intolerance; patients in their study with an IAP of 14 mmHg before EN started had a high risk of EN intolerance if their APACHE II was above 14. In our study, this IAP value of 14 mmHg was found to be the best cut-off point for predicting EN intolerance.…”

Section: Discussionmentioning

confidence: 99%

Intra-Abdominal Pressure as a Marker of Enteral Nutrition Intolerance in Critically Ill Patients. The PIANE Study

et al. 2019

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To determine whether elevated intra-abdominal pressure (IAP) is associated with a higher rate of enteral nutrition-related gastrointestinal (GI) complications; to assess the value of IAP as a predictor of enteral nutrition (EN) intolerance. Intensive Care Unit (ICU) patients on mechanical ventilation requiring at least 5 days of EN were recruited for a prospective, observational, non-interventional, multicenter study. EN was performed and GI complications were managed with an established protocol. IAP was determined via a urinary catheter. Patients who developed any GI complications were considered as presenting EN intolerance. Variables related to EN, IAP and GI complications were monitored daily. Statistical analysis compared patients without GI complications (group A) vs. GI complications (group B). 247 patients were recruited from 28 participating ICUs (group A: 119, group B: 128). No differences between groups were recorded. Patients in group B (p < 0.001) spent more days on EN (8.1 ± 8.4 vs. 18.1 ± 13.7), on mechanical ventilation (8.0 ± 7.7 vs. 19.3 ± 14.9) and in the ICU (12.3 ± 11.4 vs. 24.8 ± 17.5). IAP prior to the GI complication was (14.3 ± 3.1 vs. 15.8 ± 4.8) (p < 0.003). The best IAP value identified for EN intolerance was 14 mmHg but it had low sensitivity and specificity. Although a higher IAP was associated with EN intolerance, IAP alone did not emerge as a good predictor of EN intolerance in critically ill patients.

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