Intra-abdominal hypertension in cardiac surgery patients : a multicenter observational sub-study of the Accuryn registry
© 2022. The Author(s)..
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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
|---|---|
| Enthalten in: |
Journal of clinical monitoring and computing - 37(2023), 1 vom: 13. Feb., Seite 189-199 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Khanna, Ashish K [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 23.01.2023 Date Revised 28.03.2023 published: Print-Electronic ClinicalTrials.gov: NCT04669548 Citation Status MEDLINE |
|---|
| doi: |
10.1007/s10877-022-00878-2 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM342175696 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM342175696 | ||
| 003 | DE-627 | ||
| 005 | 20231226013506.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s10877-022-00878-2 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1140.xml |
| 035 | |a (DE-627)NLM342175696 | ||
| 035 | |a (NLM)35695943 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Khanna, Ashish K |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Intra-abdominal hypertension in cardiac surgery patients |b a multicenter observational sub-study of the Accuryn registry |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 23.01.2023 | ||
| 500 | |a Date Revised 28.03.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT04669548 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s). | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Abdominal compartment syndrome | |
| 650 | 4 | |a Cardiac surgery | |
| 650 | 4 | |a Intra-abdominal hypertension; IAH | |
| 650 | 4 | |a Intra-abdominal pressure; IAP | |
| 650 | 4 | |a Perioperative | |
| 650 | 4 | |a Real-time monitoring | |
| 650 | 7 | |a cupric oxide |2 NLM | |
| 650 | 7 | |a V1XJQ704R4 |2 NLM | |
| 700 | 1 | |a Minear, Steven |e verfasserin |4 aut | |
| 700 | 1 | |a Kurz, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Moll, Vanessa |e verfasserin |4 aut | |
| 700 | 1 | |a Stanton, Kelly |e verfasserin |4 aut | |
| 700 | 1 | |a Essakalli, Leina |e verfasserin |4 aut | |
| 700 | 1 | |a Prabhakar, Amit |e verfasserin |4 aut | |
| 700 | 0 | |a Predict AKI Group |e verfasserin |4 aut | |
| 700 | 1 | |a Harris, Lynnette C |e investigator |4 oth | |
| 700 | 1 | |a Sweatt, Nia |e investigator |4 oth | |
| 700 | 1 | |a Flores, Kelsey |e investigator |4 oth | |
| 700 | 1 | |a Reeves, Brandon |e investigator |4 oth | |
| 700 | 1 | |a Cusson, Bruce |e investigator |4 oth | |
| 700 | 1 | |a Nosow, Lillian |e investigator |4 oth | |
| 700 | 1 | |a Fanelli, Jessica |e investigator |4 oth | |
| 700 | 1 | |a Sands, Lauren |e investigator |4 oth | |
| 700 | 1 | |a Fowler, Jacob |e investigator |4 oth | |
| 700 | 1 | |a Howard, Easton |e investigator |4 oth | |
| 700 | 1 | |a Robinson, Samuel |e investigator |4 oth | |
| 700 | 1 | |a Wachnik, Anthony |e investigator |4 oth | |
| 700 | 1 | |a Fram, Madeline |e investigator |4 oth | |
| 700 | 1 | |a Fernando, Rohesh |e investigator |4 oth | |
| 700 | 1 | |a Garner, Chandrika |e investigator |4 oth | |
| 700 | 1 | |a Marchant, Bryan |e investigator |4 oth | |
| 700 | 1 | |a Morris, Benjamin |e investigator |4 oth | |
| 700 | 1 | |a Saha, Amit |e investigator |4 oth | |
| 700 | 1 | |a Egan, Katherine |e investigator |4 oth | |
| 700 | 1 | |a Blackwell, Bev Ann |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of clinical monitoring and computing |d 1998 |g 37(2023), 1 vom: 13. Feb., Seite 189-199 |w (DE-627)NLM095818405 |x 1573-2614 |7 nnns |
| 773 | 1 | 8 | |g volume:37 |g year:2023 |g number:1 |g day:13 |g month:02 |g pages:189-199 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s10877-022-00878-2 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 37 |j 2023 |e 1 |b 13 |c 02 |h 189-199 | ||