Abdominal perfusion pressure: A superior parameter in the assessment of intra-abdominal hypertension

被引:259
作者
Cheatham, ML [1 ]
White, MW [1 ]
Sagraves, SG [1 ]
Johnson, JL [1 ]
Block, EFJ [1 ]
机构
[1] Orlando Reg Med Ctr Inc, Dept Surg Educ, Orlando, FL 32806 USA
来源
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE | 2000年 / 49卷 / 04期
关键词
abdominal perfusion pressure; intra-abdominal pressure; intravesicular pressure; intra-abdominal hypertension; abdominal compartment syndrome; hemodynamic monitoring;
D O I
10.1097/00005373-200010000-00008
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To assess the clinical utility of abdominal perfusion pressure (mean arterial pressure minus intra-abdominal pressure) as both a resuscitative endpoint and predictor of survival in patients with intra-abdominal hypertension. Methods: 144 surgical patients treated for intra-abdominal hypertension between May 1997 and June 1999 were retrospectively reviewed. Multivariate logistic regression and receiver operating characteristic curve analysis of common physiologic variables and resuscitation endpoints were performed to determine the decision thresholds for each variable that predict patient survival. Results: Abdominal perfusion pressure was statistically superior to both mean arterial pressure and intravesicular pressure in predicting patient survival from intra-abdominal hypertension and abdominal compartment syndrome. Multiple regression analysis demonstrated that abdominal perfusion pressure was also superior to other common resuscitation endpoints, including arterial pH, base deficit, arterial lactate, and hourly urinary output. Conclusion: Abdominal perfusion pressure appears to be a clinically useful resuscitation endpoint and predictor of patient survival during treatment for intra-abdominal hypertension and abdominal compartment syndrome.
引用
收藏
页码:621 / 626
页数:6
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