복강 내압 항진증이 내과계 중환자의 예후에 미치는 영향 : The Effects of Intra-abdominal Hypertension on the Prognosis of Criticallyill Patients in the Intensive Care Unit(ICU)
The Effects of Intra-abdominal Hypertension on the Prognosis of Criticallyill Patients in the Intensive Care Unit(ICU)
- 주제(키워드) Abdomen , Pressure , Perfusion , Hypertension , Compartment syndrome , Critical care , Abdomen , Pressure , Perfusion , Hypertension , Compartment syndrome , Critical care
- 발행기관 대한결핵및호흡기학회
- 발행년도 2006
- 총서유형 Journal
- UCI G704-000421.2006.61.1.006
- KCI ID ART001117350
초록/요약
Background: Intra-abdominal hypertension (IAH) is defined as the presence of either an intra-abdominal pressure (IAP) ≥ 12 mmHg or an abdominal perfusion pressure (APP = mean arterial pressure IAP) ≤ 60 mmHg. Abdominal compartment syndrome (ACS) is defined as the presence of an IAP ≥ 20 mmHg together with organ failure. The purpose of this study was to investigate the prevalence of IAH and ACS on the day of admission and the effects of these maladies on the prognosis of critically ill patients in the ICU.Methods: At the day of admission to the ICU, the IAP was recorded by measuring the intravesicular pressure via a Foley catheter. The APACHE II and III scores were checked and SAPS II was also scored during the days the patients were in the ICU. The primary end point was the prevalence of IAH and ACS at the day of admission and the correlation between them with the 28-days mortality rate. The measurement of IAP continued until the 7th day or the day when the patient was transferred to the general ward before 7th day, unless the patient died or a Foley catheter was removed before 7th day. Patients were observed until death or the 28th day.Results: A total of 111 patients were enrolled. At the day of admission, the prevalence of IAH and ACS were 47.7% and 15.3%, respectively and the mean IAP was 15.1 ± 8.5 mmHg. The rates of IAH for the survivor and the non-survivor groups were 56.5% and 71.4%, respectively, and these were not significantly different (p=0.593). Yet the rates of ACS between these two groups were significantly different (4/62, 6.5% vs. 13/49, 26.5%; Odds Ratio = 5.24, 95% CI = 1.5817.30, p=0.004). Conclusion: In the present study, the prevalence of IAH was 47.7% and the prevalence of ACS was 15.3% on the day of admission. ACS was associated with a poor outcome for the critically ill patients in the ICU.(Tuberc Respir Dis 2006; 61: 46-53)
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