The abdominal perfusion pressure dynamics in patients with abdominal compartment syndrome
DOI:
https://doi.org/10.11603/2414-4533.2018.3.9440Keywords:
intraabdominal hypertension, abdominal compartment – syndrome, abdominal perfusion pressureAbstract
The aim of the work: to determine the dynamics of abdominal perfusion pressure in patients with abdominal compartment syndrome.
Materials and Methods. 30 patients with acute surgical abdominal pathology and signs of intra-abdominal hypertension were examined. Among 30 patients, 20 survived (n = 20) and 10 died (n = 10). The average age of the survivors was (55.1±14.41562), the deceased – (60.7±16.83122) years. The distribution of men and women in groups 14 and 6 in the survivor group and 4 and 6 in the deceased group, respectively. The observation period was 72 hours, on the second day one patient died. The distribution of nosologies was as follows: polytrauma – 8 (survived 6, died 2), acute destructive pancreatitis, pancreonecrosis – 8 (survived 3, died 5), acute destructive cholecystitis – 1 (died 1), intestinal obstruction – 2 (survived 1, died 1), peritonitis – 4 (survived 3, died 1), malignant neoplasm of the large intestine with perforation – 2 (survived 2), subdiaphragmatic abscess – 1 (survived 1), mechanical jaundice – 3 (survived 3), perforated ulcer of duodenum – 1 (survived 1), mesenteric thrombosis – 1 (survived 1). The dynamics of intra-abdominal and abdominal perfusion pressure during the follow-up period is indicated in Tables 1 to 4.
Results and Discussion. As a result of the mathematical analysis, there was no significant difference in the age of patients and the magnitude of intra-abdominal and abdominal perfusion pressure in the first 24 hours of follow-up. However, later (from the end of the first day) the differences became reliable and this trend was observed up to 72 hours of observation. The lethal outcome was established in patients with progressive decrease in APP despite the use of intensive inotropic support, optimization of infusion and transfusion therapy, and mechanical ventilation. Also, there was no significant difference in the use of blood products in the first day, the volume of infusions and the volume of diuresis, but there was a significant difference in the need for inotropic support and a dose of inotropic agents.
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