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Prevalence of Intraabdominal Hypertension and Abdominal Compartment Syndrome in an Intensive Care Unit FREE TO VIEW

Jesus Sosa Garcia, MD; Angel Perez Calatayud, MD; Raul Carrillo Esper, MD
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Centro Nacional de Excelencia Tecnológica en Salud, México, DF, Mexico

Chest. 2014;145(3_MeetingAbstracts):193A. doi:10.1378/chest.1835880
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SESSION TITLE: Critical Care Posters III

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: To determine the prevalence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS), and its correlation with mortality, APACHE II, SOFA, fluid balance and lactate.

METHODS: We design a prospective non-randomized study in the Intensive Care Unit (ICU) from March to October of 2009. We included patients of both genders, 18 years old or more, with medical o surgical illness, and an in hospital stay of at least 24 hrs. We monitored the intra-abdominal pressure (IAP) by bladder pressure every 4 to 6 hours and in high risk patients every hour. For the statistical analysis we applied a descriptive statistics, for prevalence and mortality we used a “T” student analysis for a p value of p=0.05, for interdependence of the variables we used a Pearson correlation.

RESULTS: We analyzed a total of 110 patients, we excluded 17. The 93 patients included were distributed in 3 groups according to the degree of IAP. 52 patients had normal IAP, 32 presented IAH and 9 ACS. 55 patients had a medical illness and 38 had a surgical one. The prevalence of IAH was 34% and ACS 10%. Medical illness caused 62.5% of the cases and 66.6% of ACS had a primary origin with a mortality of 15%. APACHE II and SOFA score were higher in patients with IAH and ACS. We evidenced an interdependence between fluid balance, lactate levels and IAP without a statistical significance for p=0.05.

CONCLUSIONS: IAH is en frequent entity in the ICU, witch associates to different degrees of organ dysfunction and when not treated, it evolves to ACS incrementing morbidity and mortality.

CLINICAL IMPLICATIONS: IAP measure should be implemented in ICU patients for early detection of IAH and ACS.

DISCLOSURE: The following authors have nothing to disclose: Jesus Sosa Garcia, Angel Perez Calatayud, Raul Carrillo Esper

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