Izvorni znanstveni članak
Correlation between intra-abdominal hypertension and arterial lactate concentration in severe sepsis patients
MARIO PAVLEK
orcid.org/0000-0002-1848-247X
; Zagrebačka cesta 128, 10000 Zagreb, Croatia
ŽELJKO DRVAR
; Zagrebačka cesta 128, 10000 Zagreb, Croatia
MIRJANA MIRIĆ
; Zagrebačka cesta 128, 10000 Zagreb, Croatia
ROBERT BARONICA
; Zagrebačka cesta 128, 10000 Zagreb, Croatia
DANIJELA BANDIĆ-PAVLOVIĆ
; Zagrebačka cesta 128, 10000 Zagreb, Croatia
MLADEN PERIĆ
; Zagrebačka cesta 128, 10000 Zagreb, Croatia
Sažetak
Intra-abdominal hypertension (IAH) in severe sepsis patients with consequent multiple organ failure is associated with
increased arterial lactate levels. In this nonrandomized, prospective control trial, the correlation between intra-abdominal
hypertension and arterial lactate concentration in severe sepsis patients was analysed.
Thirty-eight patients undergoing major abdominal surgery with confirmed severe sepsis constituted the severe sepsis
patients group. Control group included thirty-eight patients undergoing elective abdominal surgery with at least two risk
factors for IAH.
Intra-abdominal pressure (IAP) was assessed in both groups every six hours during the first 72 hours, through a Foley catheter
placed in the urinary bladder. IAH was diagnosed with two consecutive measurements of IAP >12mmHg. At the same
time lactate levels in arterial blood, SvO2 and CVP were assessed. Data were compared using Student’s t test. P <0.05
was considered statistically significant. In the sepsis group, 25 patients (65.8%) had IAP >12mmHg, 10 patients (26.3%)
had IAP >16mmHg and three patients (7.9%) had IAP >20mmHg. In the control group, all patients had IAP up to 7mmHg.
Arterial blood lactate levels were significantly increased in severe sepsis patients with IAP >16mmHg (4,2mmol/L versus
1,2mmol/L, P<0.05) compared to the control group. Mortality in severe sepsis patients with IAH was 24.5% (10 patients).
Arterial blood lactate levels were significantly higher in severe sepsis patients IAH >16mmHg compared to control group.
Continuous IAP monitoring in severe sepsis patients is important for early detection of splanchnic hypoperfusion with consequent
multi-organ failure, and for timely application of efficacious therapeutic procedures.
Ključne riječi
intra-abdominal hypertension; arterial lactate concentration; sepsis
Hrčak ID:
134146
URI
Datum izdavanja:
1.6.2014.
Posjeta: 755 *