Intra-abdominal hypertension and hypoxic respiratory failure together predict adverse outcome - A sub-analysis of a prospective cohort.
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Regli Adrian, Reintam Blaser Annika, De Keulenaer Bart, Starkopf Joel, Kimball Edward, Malbrain Manu L N G, Van Heerden Peter Vernon, Davis Wendy A, IROI Study Investigators, 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, Santos Maicol Dos, Kirov Mikhail, Smetkin Alexey, Ilyina Yana, Gilsdorf Daniel, Ordoñez Carlos A, Caicedo Yaset, Greiffenstein Patrick, Morgan Margaret M, Bodnar Zsolt, Tidrenczel Edit, Oliveira Gina, Albuquerque Ana, Pereira Bruno M
Аннотация
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.