Incidence of intra-abdominal hypertension and its risk foctors in critically ill patients

Abstract

Objective To discuss the incidence of intra-abdominal hypertension (IAH) and its risk factors in critically ill patients. Methods Prospective cohort study was carried out in our general intensive care unit (ICU). A total of fifty-four patients were enrolled between July 2013 and November 2013.Intra-abdominal pressure (IAP) was measured though the urinary bladder catheter indirectly.Indicators including demographics, main diagnosis on admission, mechanically ventilated and the PEEP (positive end-expiratory pressure), laparotomy, clinical test results, CVP, cumulative fluid balance, severity scores and so on were recorded.Logistic regression analysis was used to investigate risk factors of IAH.Risk factors of IAH were analyzed by logistic regression. Results In our study, the incidence of IAH in critical patients was 37.0%(20/54), including ten persons in Grade Ⅰ, eight persons in Grade Ⅱ, two persons in Grade Ⅲ, none in Grade Ⅳ.Higher acute physiology and chronic health scores (APACHE-Ⅱ) [(20.1±6.2) scores, (14.9±5.6) scores, t=8.04, P<0.05], Sequential organ failure assessment (SOFA) scores [(10.4±6.4)scores, (5.5±4.3) scores, t=7.31, P<0.05], central venous pressure[ (10.4±2.8)mmHg, (8.9±2.0)mmHg, t=6.21, P<0.05)]were measured in patients with IAH than those in patients without IAH.Risk factors associated with IAH were mechanical ventilation, ascites, septic shock and disorders of biliary system(P<0.05). Conclusions The high incidence of IAH is observed in ICU critical patients, mainly in mild and moderate degree.And a close correlation is found between IAH and its risk factors including mechanical ventilatia ascites, septic shock and disorders of biliary system. Key words: Critically illness; Abdominal compartment syndrome; Risk factors