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Background: Intra-abdominal pressure (IAP) and intra-abdominal hypertension (IAH) are associated with significant morbidity and mortality in critically ill patients. Our aim was to assess the effects of IAH on liver function using the noninvasive liver function monitoring system LiMON and to assess the prognostic value of IAP in critically ill patients. Methods: We conducted a retrospective analysis of critically ill patients who were treated in the intensive care unit (ICU). The IAP and indocyanine green plasma disappearance rate (ICG-PDR) measurements were made within 24 hours after admission to the ICU and repeated 12 hours later. Intra-abdominal pressure was measured via a Foley bladder catheter, and ICG elimination tests were conducted concurrently using the LiMON. Results: We included 30 critically ill patients (17 women and 13 men aged 28-89 yr) in our analysis. Statistical analysis showed that the baseline IAP values were significantly higher among nonsurvivors than survivors (19.38 [standard deviation; SD 2.08] v. 13.07 [SD 0.99]). The twelfth-hour IAP values were higher than baseline measurements among nonsurvivors (21.50 [SD 1.96]) and lower than baseline measurements among survivors (11.71 [SD 1.54]); the difference between groups was significant (p < 0.001). The baseline ICG-PDR values were significantly lower among nonsurvivors than survivors (10.86 [SD 3.35] v. 24.51 [SD 6.78]), and the twelfth-hour ICG-PDR values were decreased in all groups; the difference between groups was significant (p < 0.001). Conclusion: Our results suggest that measurement of ICG-PDR with the LiMON is a good predictor of the effects of IAP on liver function and, thus, can be recommended for the evaluation of critically ill patients. Contexte: L'elevation de la pression intra-abdominale (PIA) et l'hypertension intraabdominale sont associees a des taux importants de morbidite et de mortalite chez les patients en etat critique. Nous voulions evaluer les effets de l'hypertension intraabdominale sur la fonction hepatique en utilisant le systeme de surveillance non effractif de la fonction lymphatique LiMON et evaluer la valeur de la PIA comme pronostic chez des patients en etat critique. Methodes: Nous avons procede a une analyse retrospective des dossiers de patients en etat critique traites aux soins intensifs. Les mesures de la PIA et du taux de disparition plasmatique du vert d'indocyanine (TDP-VIC) ont ete effectuees dans les 24 heures suivant l'admission aux soins intensifs et repetees 12 heures plus tard. On a mesure l'elevation de la pression intra-abdominale au moyen d'une sonde vesicale de Foley et on a effectue des mesures du TDP-VIC simultanement au moyen du systeme LiMON. Resultats: Notre analyse a porte sur 30 patients en etat critique (17 femmes et 13 hommes ages de 28 a 89 ans). L'analyse statistique a demontre que les valeurs de reference de la PIA etaient beaucoup plus elevees chez les non survivants que chez les survivants (19,38 [ecart-type; ET 2,08] c. 13,07 [ET 0,99]). Les valeurs de la PIA a 12 heures etaient plus elevees que les mesures de reference chez les non survivants (21,50 [ET 1,96]) et moins elevees que les mesures de reference chez les survivants (11,71 [ET 1,54]). La difference entre les groupes etait significative (p < 0,001). Les valeurs de reference du TDP-VIC etaient beaucoup moins elevees chez les non survivants que chez les survivants (10,86 [ET 3,35] c. 24,51 [ET 6,78]) et les valeurs du TDP-VIC a 12 heures avaient diminue dans tous les groupes. La difference entre les groupes etait significative (p < 0,001). Conclusion: Nos resultats indiquent que la mesure du TDP-VIC au moyen du systeme LiMON constitue un bon predicteur des effets de la PIA sur la fonction hepatique et qu'il est donc possible de la recommander pour evaluer des patients en etat critique., Intra-abdominal pressure (IAP) is the steady-state pressure concealed within the abdominal cavity and is influenced by body weight, body position and abdominal muscle activity. (1-3) A transient increase in IAP, [...]

Amaç: Artmış karın içi basıncın kafa içi basıncı üzerine zararlı etkileri vardır. Bu gözlemsel çalışmada, majör cerrahi geçiren hastalarda karın içi basınç değerlerinin ultrason yardımıyla ölçülen optik sinir kılıf çapı (ONSD) ölçümü üzerine olan etkilerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışmaya 78 hasta dahil edildi. Tüm hastaların yaşı, cinsiyeti, kilosu, ameliyat türleri, ek hastalıkları, APACHE, SOFA skoru, ameliyat süresi ve ameliyat sırasında verilen sıvı miktarı kaydedildi. Tüm hastaların yoğun bakım ünitesinde yatış süresi ve prognozları kaydedildi. Hasta yoğun bakım ünitesine alındıktan sonra ve 6 saatte bir IAB ölçüldü. ONSD ölçümleri, IAB değerlerinin ölçümü ile eş zamanlı olarak yapıldı. IAB, ONSD ve diğer parametreler 24 saat takip edildi. Bulgular: Karın içi basınç, sol ONSD, sağ ONSD, kalp hızı ölçümleri grup 2 ve grup 3’te grup 1’e göre anlamlı olarak yüksekti (her biri için p<0,001) grup 1 ile karşılaştırıldığında grup 3’te anlamlı olarak daha yüksekti (p<0,001). Sonuç: IAB ve ICB arasındaki ilişkiyi tanımlayan mekanizmalar araştırılmıştır. Bir çalışma, merkezi sinir sistemi venöz dolaşımındaki azalmanın ve sagital sinüste sekonder basıncın artmasının omurilik sıvısı basıncında artışa neden olduğunu bildirmiştir. Karın içi basıncı yüksek olan hastalarda ultrasonografi ile ONSD takibi yapılmasını önermekteyiz. [ABSTRACT FROM AUTHOR]

Objective: As a result of advanced mechanical ventilation and hemodynamic support applications, the duration of intensive care stay is prolonged. Investigation of effective causes of prolonged ICU stay is important in terms of effective use of intensive care units. Materials and Methods: Patients who were hospitalized for more than 24 hours in the ICU during one year were included into the study. Age, gender, Body Mass index, hospitalization, location (emergency, operating room, service), presence of operation, presence of emergency / elective operation, need for vasopressor, Glaskow coma score (GCS), Full Outline of Unresponsiveness score (FOUR), Acute Physiology and Chronic Health Evaluation score, simplified acute physiology (SAPS III) score, hemogram profile, biochemical profile and coagulation profile values were recorded. All patients were classified as stay in the intensive care unit for shorter than 14 days and 14 days and more. We tried to investigate factors affecting prolonged admission by comparing these values. Results: Advanced age, high urea value, low GCS, low FOUR score, high SAPS III value, need for MV and need for vasoactive agent were found to be effective factors in prolonged intensive care hospitalization. Conclusion: We think that extensive studies should be done in this area as more effective use of intensive care units may be possible as a result of trying to reveal the factors affecting prolonged intensive care. [ABSTRACT FROM AUTHOR]

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Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)