EFFECT OF INCREASED INTRA-ABDOMINAL PRESSURE ON PROGNOSIS OF PATIENTS IN THE INTENSIVE CARE UNIT

TONG WANG, ZHEN WANG#, YINGYA CAO, WEIHUA LU, GUANGGUI SHEN

Department of Critical Care Medicine The First Affiliated Hospital Of Wannan Medical College, Yijishan Hospital, Wuhu, China, 241000

Objective: The objective is to evaluate the effect intra-abdominal pressure on the prognosis of patients in the intensive care unit (ICU).

Methods: Patients admitted to the ICU for more than 24 hours from November 2015 to May 2016 were enrolled. Their intra-abdominal pressure was measured within 24, 48, and 72 hours. The patients were divided into an intra-abdominal hypertension (IAH) group with greater than or equal to 12 mmHg of pressure and a normal intra-abdominal pressure (normal) group. The following were analysed: 1) the correlation between intra-abdominal pressure and the sequential organ failure assessment (SOFA) score, 2) the effect of the number of days in the ICU between the IAH group and the normal group, 3) the 28-day survival rate, and 4) the mechanical ventilation time.

Results: Patients in the IAH group accounted for 72.3% of patients within 24 hours in the ICU. No significant difference in gender, age, body mass index, and albumin three-day change level existed between the two groups. Among the patients, 24.62% were postoperative, 21.54% suffered brain trauma, and 21.54% presented multiple organ dysfunction syndrome. No statistically significant change in intra-abdominal pressure was found during the three days. Compared with the surviving patients, the intra-abdominal pressure in those who died was higher. The patients in the IAH group had a longer mechanical ventilation and ICU stay times than the normal group, and the difference was statistically significant. A correlation was found between intra-abdominal pressure and the SOFA score.

Conclusion: Intra-abdominal pressure can be used as a predictive index to evaluate the condition of critically ill patients. A higher intra- abdominal pressure indicates a worse patient prognosis. A longer stay in the ICU correlates with a higher mortality rate. Intra-abdominal pressure can be used as an independent influencing factor of the ICU stay time but cannot be an independent factor in the patient mortality rate.