Intra-Abdominal Hypertension and Hypoxic Respiratory Failure Together Predict Adverse Outcome – a Sub-Analysis of a Prospective Cohort


Adrian Regli, Fiona Stanley Hospital
Annika Reintam Blaser, Tartu Ülikool
Bart De Keulenaer, Fiona Stanley Hospital
Joel Starkopf, Tartu Ülikool
Edward Kimball, University of Utah School of Medicine
Manu Malbrain, Vrije Universiteit Brussel
Peter Vernon Van Heerden, Hadassah University Medical Centre
Wendy A. Davis, The University of Western Australia
Annamaria Palermo, Fiona Stanley Hospital
Wojciech Dabrowski, Medical University of Lublin
Dorota Siwicka-Gieroba, Medical University of Lublin
Malgorzata Barud, Medical University of Lublin
Ioana Grigoras, Universitatea de Medicina si Farmacie Grigore T. Popa din Iasi
Anca Irina Ristescu, Universitatea de Medicina si Farmacie Grigore T. Popa din Iasi
Adina Blejusca, Regional Institute of Oncology
Kadri Tamme, Tartu Ülikool
Liivi Maddison, Tartu Ülikooli Kliinikum
Ülle Kirsimägi, Tartu Ülikooli Kliinikum
Andrey Litvin, Immanuel Kant Baltic Federal University
Anastasiya Kazlova, Gomel Regional Clinical Hospital
Aliaksandr Filatau, Gomel Rigional Clinical Hospital
Francisco Pracca, University Hospital, Udelar
Gustavo Sosa, UDELAR, Montevideo, Uruguay
Maicol Dos Santos, UDELAR, Montevideo, Uruguay
Mikhail Kirov, Northern State Medical University
Alexey Smetkin, Northern State Medical University
Yana IIyina, Northern State Medical University
Daniel Gilsdorf, University of Utah School Medicine
Carlos Ordonez, Universidad del Valle
Yaset Caicedo, Centro de Investigaciones Clínicas (CIC), Fundacion Valle del Lili, Cali, Colombia
Patrick Greiffenstein, LSU Health Sciences Center- New OrleansFollow
et al

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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.

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