Deterioration of mechanically ventilated patients in the presence of intra-abdominal hypertension

Abstract

Background and objective: Elevated pressure within the cavity of the abdomen is a serious complication that can threat the life of critically ill patients. Thus, there is an intense need to highlight the outcomes of intra-abdominal hypertension (IAH) that can face critical care nurses. This work aimed to explore the deterioration of mechanical ventilated patients in the presence of IAH.

Methods: Design: A non-randomized prospective study. Procedures: This trial was implemented in trauma and general intensive care in the period between December 2015 and August 2016. The pressure within the abdomen was measured for each patient, three times with 8-hr interval, at the third day of mechanical ventilator (MV). Sepsis-related organ failure assessment score was measured for all patients at first day of admission. All patients who had normal intra-abdominal pressure (IAP) or developed IAH were observed, monitored and evaluated for the clinical outcomes until discharged. 

Results: Of the 60 MV patients, 83.3% developed IAH. Higher mean of MV and stay period among patients with increased pressure within the abdomen (14.04 ± 10.30 and 16.30 ± 9.36) than normotensive patients (6.90 ± 2.80 and 11.000 ± 3.77) with significant difference (p = .001). Non-survivor had a significantly higher mean IAP than survivor (23.266 ± 2.37 vs. 7.91 ± 3.17) (p value < .001).

Conclusions: The occurrence of IAH complicated 83.3% of mechanical ventilated clients in the study period: like longer stay and use of ventilator, and high mortality rate.