Intra-abdominal hypertension in cardiac surgery patients: a multicenter observational sub-study of the Accuryn registry.
Abdominal compartment syndrome
Cardiac surgery
Intra-abdominal hypertension; IAH
Intra-abdominal pressure; IAP
Perioperative
Real-time monitoring
Journal
Journal of clinical monitoring and computing
ISSN: 1573-2614
Titre abrégé: J Clin Monit Comput
Pays: Netherlands
ID NLM: 9806357
Informations de publication
Date de publication:
02 2023
02 2023
Historique:
received:
25
01
2022
accepted:
06
05
2022
pubmed:
14
6
2022
medline:
24
1
2023
entrez:
13
6
2022
Statut:
ppublish
Résumé
Intra-abdominal hypertension (IAH) is frequently present in the critically ill and is associated with increased morbidity and mortality. Conventionally, intermittent 'spot-check' manual measurements of bladder pressure in those perceived as high risk are used as surrogates for intra-abdominal pressure (IAP). True patterns of IAH remain unknown. We explored the incidence of IAH in cardiac surgery patients and describe the intra-and postoperative course of IAP using a novel, high frequency, automated bladder pressure measurement system. Sub-analysis of a prospective, multicenter, observational study (NCT04669548) conducted in three large academic medical centers. Continuous urinary output (CUO) and IAP measurements were observed using the Accuryn Monitoring System (Potrero Medical, Hayward, CA). Data collected included demographics, hemodynamic support, and high-frequency IAP and CUO. One Hundred Thirty-Seven cardiac surgery patients were analyzed intraoperatively and followed 48 h postoperatively in the intensive care unit. Median age was 66.4 [58.3, 72.0] years, and 61% were men. Median Foley catheter dwell time was 56.0 [46.8, 77.5] hours, and median baseline IAP was 6.3 [4.0, 8.1] mmHg. 93% (128/137) of patients were in IAH grade I, 82% (113/137) in grade II, 39% (53/137) in grade III, and 5% (7/137) in grade IV for at least 12 cumulative hours. For maximum consecutive duration of IAH, 84% (115/137) of patients spent at least 12 h in grade I, 62% (85/137) in grade II, 18% (25/137) in grade III, and 2% (3/137) in grade IV IAH. During the first 48 h after cardiac surgery, IAH is common and persistent. Improved and automated monitoring of IAP will increase the detection of IAH-which normally would remain undetected using traditional intermittent monitoring methods.
Identifiants
pubmed: 35695943
doi: 10.1007/s10877-022-00878-2
pii: 10.1007/s10877-022-00878-2
pmc: PMC9852117
doi:
Substances chimiques
cupric oxide
V1XJQ704R4
Banques de données
ClinicalTrials.gov
['NCT04669548']
Types de publication
Observational Study
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
189-199Investigateurs
Lynnette C Harris
(LC)
Nia Sweatt
(N)
Kelsey Flores
(K)
Brandon Reeves
(B)
Bruce Cusson
(B)
Lillian Nosow
(L)
Jessica Fanelli
(J)
Lauren Sands
(L)
Jacob Fowler
(J)
Easton Howard
(E)
Samuel Robinson
(S)
Anthony Wachnik
(A)
Madeline Fram
(M)
Rohesh Fernando
(R)
Chandrika Garner
(C)
Bryan Marchant
(B)
Benjamin Morris
(B)
Amit Saha
(A)
Katherine Egan
(K)
Bev Ann Blackwell
(BA)
Informations de copyright
© 2022. The Author(s).
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