Mild to moderate intra-abdominal hypertension:Does it matter?

• 作者: Annika Reintam Blaser Joel Starkopf Liivi Maddison
• 来源期刊: 世界重症医学杂志
• 学科: 医学
• 关键词: INTRA-ABDOMINAL pressure INTRA-ABDOMINAL hypertension PATHOPHYSIOLOGY EPIDEMIOLOGY SEVERITY Treatment
• 年，卷（期）: sjzzyxzz_2016,（1）
• 页码范围: 96-102
• 页数: 7页
• 分类号: R

摘要

This review summarizes the epidemiology,pathophysiological consequences and impact on outcome of mild to moderate(GradeⅠtoⅡ)intra-abdominal hypertension(IAH),points out possible pitfalls in available treatment recommendations and focuses on tasks for future research in the field.IAH occurs in about 40%of ICU patients.Whereas the prevalence of abdominal compartment syndrome seems to be decreasing,the prevalence of IAH does not.More than half of IAH patients present with IAH gradeⅠand approximately a quarter with IAH gradeⅡ.However,most of the studies have addressed IAH as a yes-or-no variable,with little or no attention to different severity grades.Even mild IAH can have a negative impact on tissue perfusion and microcirculation and be associated with an increased length of stay and duration of mechanical ventilation.However,the impact of IAH and its different grades on mortality is controversial.The influence of intra-abdominal pressure(IAP)on outcome most likely depends on patient and disease characteristics and the concomitant macro-and microcirculation.Therefore,management might differ significantly.Today,clear triggers for interventions in different patient groups with mild to moderate IAH are not defined.Further studies are needed to clarify the clinical importance of mild to moderate IAH identifying clear triggers for interventions to lower the IAP.