1. Intra-Abdominal Pressure as a Marker of Enteral Nutrition Intolerance in Critically Ill Patients. The PIANE Study
- Author
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Luisa Bordeje, M., Montejo, Juan C., Lidon Mateu, M., Solera, Manuel, Acosta, Jose A., Juan, Mar, Garcia-Cordoba, Francisco, Garcia-Martinez, Miguel A., Gastaldo, Rosa, Acosta, Jose, Albert, Inmaculada, Alec, Alfonso, Luisa Bordeje, Ma, Calvo, Enrique, Ferre, Merce, Garcia de Lorenzo, Abelardo, Angel Garcia-Martinez, Miguel, Gonzalez-Iglesias, Carlos, Iglesias, Rayden, Lorencio, Carol, Martinez de la Gandara, Amalia, Lidon Mateu, Ma, Mesejo, Alfonso, Martinez-Garcia, Pilar, Carlos Montejo, Juan, Luisa Navarrete, Ma, Ortiz-Leyba, Carlos, Robles, Angel, Sanchez-Alvarez, Carmen, Vaquerizo, Clara, Vila, Belen, Carlos Yebenes, Juan, Zabarte, Mercedes, and PIANE STUDY GRP SPAIN
- Subjects
Male ,Gastrointestinal Diseases - etiology ,Gastrointestinal Diseases ,medicine.medical_treatment ,humanos ,asistencia del enfermo crítico ,intensive care unit ,Gastroenterology ,Enteral administration ,Group B ,law.invention ,0302 clinical medicine ,law ,estudios prospectivos ,Abdomen ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,mediana edad ,anciano ,Nutrition and Dietetics ,Respiration ,enfermedades gastrointestinales ,respiración ,gastrointestinal complications ,Middle Aged ,Intensive care unit ,Intensive Care Units ,presión ,medicine.anatomical_structure ,intra-abdominal pressure ,Female ,lcsh:Nutrition. Foods and food supply ,medicine.medical_specialty ,Critical Care ,Critical Illness ,unidades de cuidados intensivos ,enfermedad crítica ,lcsh:TX341-641 ,Article ,enteral nutrition intolerance ,03 medical and health sciences ,Internal medicine ,Pressure ,medicine ,Humans ,enteral nutrition ,nutrición enteral ,Aged ,Mechanical ventilation ,business.industry ,030208 emergency & critical care medicine ,Respiration, Artificial ,Critical Illness - therapy ,Parenteral nutrition ,business ,Complication ,Biomarkers ,Food Science - Abstract
To determine whether elevated intra-abdominal pressure (IAP) is associated with a higher rate of enteral nutrition-related gastrointestinal (GI) complications, to assess the value of IAP as a predictor of enteral nutrition (EN) intolerance. Intensive Care Unit (ICU) patients on mechanical ventilation requiring at least 5 days of EN were recruited for a prospective, observational, non-interventional, multicenter study. EN was performed and GI complications were managed with an established protocol. IAP was determined via a urinary catheter. Patients who developed any GI complications were considered as presenting EN intolerance. Variables related to EN, IAP and GI complications were monitored daily. Statistical analysis compared patients without GI complications (group A) vs. GI complications (group B). 247 patients were recruited from 28 participating ICUs (group A: 119, group B: 128). No differences between groups were recorded. Patients in group B (p <, 0.001) spent more days on EN (8.1 ± 8.4 vs. 18.1 ± 13.7), on mechanical ventilation (8.0 ± 7.7 vs. 19.3 ± 14.9) and in the ICU (12.3 ± 11.4 vs. 24.8 ± 17.5). IAP prior to the GI complication was (14.3 ± 3.1 vs. 15.8 ± 4.8) (p <, 0.003). The best IAP value identified for EN intolerance was 14 mmHg but it had low sensitivity and specificity. Although a higher IAP was associated with EN intolerance, IAP alone did not emerge as a good predictor of EN intolerance in critically ill patients.
- Published
- 2019