Clinical value of early continuous blood purification in intra abdominal hypertension after abdominal trauma operation

Abstract

Objective To investigate clinical value of early continuous blood purification (CBP)in intra abdominal hypertension(IAH) of postoperative abdominal trauma. Methods The thirty-five patients with IAH of postoperative abdominal trauma in intensive care unit (ICU)of the second affiliated hospital of Fujian medical college from September 2008 to March 2014 were retrospecively analysed, including early CBP group (seventeen cases) and control group (eighteen cases). The cases with abdominal compartment syndrome (ACS), the duration of IAH, prognosis, the mean arterial pressure, the level of oxygenation index(PaO2 /FiO2), the average of IAP and the lactic acid level of two groups were compared. Results The cases of ACS and death in early stage of CBP(four cases and two cases respectively ) were significantly decreased than those in control group (thirteen-three cases and nine cases respectively)(χ2=8.30, 5.93; P<0.05); The duration of IAH [(3.22±1.47)d] in early stage of CBP was significantly shorter than that in control group[(6.53± 2.38)d](t=4.91, P<0.05). The mean arterial pressure[(92.17±8.37)mmHg] (1 mmHg=0.133 kpa), the level of PaO2/FiO2(309.8±74.7)in early stage of CBP were higher than those in control group [(68.92±8.35)mmHg, (256.6±85.5)](t=8.22, 2.04; P<0.05). The average of IAP (11.81±1.59)and the lactic acid level [(2.05±1.31)mmol/L] in early CBP were lower than those in control group, [(18.38±3.87), (3.35±1.44)mmol/L] , (t=6.50, 2.79; P<0.05). Conclusion The use of early CBP in IAH after abdominal trauma operation is the effective treatment measure for reducing IAP and prevention of ACS. Key words: After abdominal trauma operation; Intra abdominal hypertension; Abdominal compartment syndrome; Continuous blood purification