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首页> 外文期刊>Acta Anaesthesiologica Scandinavica >Early screening to identify patients at risk of developing intra-abdominal hypertension and abdominal compartment syndrome
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Early screening to identify patients at risk of developing intra-abdominal hypertension and abdominal compartment syndrome

机译：早期筛查以发现有发生腹内高压和腹腔室综合征风险的患者

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Background: To develop a screening tool to identify patients at risk of developing intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) within 24 h of a patient's admission to intensive care unit (ICU). Methods: Prospective, observational study of 403 consecutively enrolled patients with an indwelling catheter, admitted to a mixed medical-surgical ICU in a tertiary referral, university hospital. Intra-abdominal pressure was measured at least twice daily and IAH and ACS defined as per consensus definitions. Results: Thirty-nine per cent of patients developed IAH and 2% developed ACS. Abdominal distension, hemoperitoneum/pneumoperitoneum/intra-peritoneal fluid collection, obesity, intravenous fluid received > 2.3 l, abbreviated Sequential Organ Failure Assessment score > 4 points and lactate > 1.4 mmol/l were identified as independent predictors of IAH upon admission to ICU. The presence of three or more of these risk factors at admission identified patients that would develop IAH with a sensitivity of 75% and a specificity of 76%, the development of grades II, III and IV IAH with a sensitivity of 91% and a specificity of 62%. Patients that developed IAH required a significantly longer duration of mechanical ventilation and ICU care. Patients that developed grades II-IV IAH had a significantly higher rate of ICU mortality. Conclusion: IAH is a common clinical entity in the intensive care setting that is associated with morbidity and mortality. A screening tool, based on data readily available within a patient's first 24 h in ICU, was developed and effectively identified patients that required intra-abdominal pressure monitoring.
机译：背景：开发一种筛查工具，以识别在重症监护病房（ICU）入院后24小时内有发生腹腔内高压（IAH）和腹腔室综合征（ACS）风险的患者。方法：前瞻性观察性研究对403例连续住院的患者进行了研究，这些患者在大学转诊的三级转诊医院接受了混合外科手术加护病房。每天至少测量两次腹腔内压力，并按照共识定义确定IAH和ACS。结果：39％的患者发生了IAH，2％的患者发生了ACS。入ICU时，腹胀，腹膜/气腹/腹腔积液，肥胖，接受的静脉输液量大于2.3升，顺序器官功能衰竭评估分数> 4分和乳酸> 1.4 mmol / l被确定为IAH的独立预测因子。入院时存在上述危险因素中的三个或三个以上的患者，会发展为IAH，敏感性为75％，特异性为76％，发展为II，III和IV级IAH，敏感性为91％，特异性占62％。发生IAH的患者需要更长的机械通气时间和ICU护理时间。发生II-IV级IAH的患者的ICU死亡率显着更高。结论：IAH是重症监护中常见的临床实体，与发病率和死亡率相关。根据患者在ICU最初24小时内可获得的数据，开发了一种筛查工具，可以有效地识别需要进行腹腔内压力监测的患者。

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