Intra-Abdominal Hypertension and Hypoxic Respiratory Failure Together Predict Adverse Outcome – a Sub-Analysis of a Prospective Cohort
Journal of Critical Care
Purpose: To assess whether the combination of intra-abdominal hypertension (IAH, intra-abdominal pressure ≥ 12 mmHg) and hypoxic respiratory failure (HRF, PaO2/FiO2 ratio < 300 mmHg) in patients receiving invasive ventilation is an independent risk factor for 90- and 28-day mortality as well as ICU- and ventilation-free days. Methods: Mechanically ventilated patients who had blood gas analyses performed and intra-abdominal pressure measured, were included from a prospective cohort. Subgroups were defined by the absence (Group 1) or the presence of either IAH (Group 2) or HRF (Group 3) or both (Group 4). Mixed-effects regression analysis was performed. Results: Ninety-day mortality increased from 16% (Group 1, n = 50) to 30% (Group 2, n = 20) and 27% (Group 3, n = 100) to 49% (Group 4, n = 142), log-rank test p < 0.001. The combination of IAH and HRF was associated with increased 90- and 28-day mortality as well as with fewer ICU- and ventilation-free days. The association with 90-day mortality was no longer present after adjustment for independent variables. However, the association with 28-day mortality, ICU- and ventilation-free days persisted after adjusting for independent variables. Conclusions: In our sub-analysis, the combination of IAH and HRF was not independently associated with 90-day mortality but independently increased the odds of 28-day mortality, and reduced the number of ICU- and ventilation-free days.
Regli, Adrian; Reintam Blaser, Annika; De Keulenaer, Bart; Starkopf, Joel; Kimball, Edward; Malbrain, Manu; Van Heerden, Peter Vernon; Davis, Wendy A.; Palermo, Annamaria; Dabrowski, Wojciech; Siwicka-Gieroba, Dorota; Barud, Malgorzata; Grigoras, Ioana; Ristescu, Anca Irina; Blejusca, Adina; Tamme, Kadri; Maddison, Liivi; Kirsimägi, Ülle; Litvin, Andrey; Kazlova, Anastasiya; Filatau, Aliaksandr; Pracca, Francisco; Sosa, Gustavo; Dos Santos, Maicol; Kirov, Mikhail; Smetkin, Alexey; IIyina, Yana; Gilsdorf, Daniel; Ordonez, Carlos; and Caicedo, Yaset, "Intra-Abdominal Hypertension and Hypoxic Respiratory Failure Together Predict Adverse Outcome – a Sub-Analysis of a Prospective Cohort" (2021). School of Medicine Faculty Publications. 366.