Intra-abdominal pressure and abdominal perfusion pressure in cirrhotic patients with septic shock

Al-Dorzi, Hasan M; Tamim, Hani M; Rishu, Asgar H; Aljumah, Abdulrahman; Arabi, Yaseen M

doi:10.1186/2110-5820-2-S1-S4

Annals of Intensive Care

Table 1 Characteristics of patients according to mean IAP and APP on the first ICU admission day.

From: Intra-abdominal pressure and abdominal perfusion pressure in cirrhotic patients with septic shock

	All patients	IAP^a < 12 mmHg	IAP^a ≥ 12 mmHg	p value	APP^a ≥ 60 mmHg	APP^a < 60 mmHg	p value
	N = 61	N = 11	N = 50		N = 18	N = 43
Age in years, mean ± SD	59.8 ± 12.2	63.6 ± 7.4	59.0 ± 13.0	0.26	59.0 ± 14.2	60.2 ± 11.5	0.74
Male sex, N (%)	36 (59.0)	7 (63.7)	29 (58.0)	1.00	7 (38.9)	18 (41.9)	0.83
Body mass index (Kg/m²), mean ± SD	26.8 ± 5.9	26.5 ± 6.3	26.9 ± 5.9	0.87	26.3 ± 6.5	27.0 ± 5.8	0.70
Etiology of liver cirrhosis, N (%)
Hepatitis C	30 (49.2)	8 (73.0)	22 (44.0)		7 (39.0)	23 (53.0)
Hepatitis B	17 (27.9)	2 (18.0)	15 (30.0)	0.27	6 (33.0)	11 (26.0)	0.56
Others	14 (23.0)	1 (9.0)	13 (26.0)		5 (28.0)	9 (21.0)
Child-Pugh score, mean ± SD	11.6 ± 1.6	11.2 ± 1.4	11.6 ± 1.6	0.39	11.2 ± 1.9	11.7 ± 1.4	0.29
APACHE II score, mean ± SD	30.1 ± 7.5	23.9 ± 7.7	31.5 ± 6.7	0.002	29.9 ± 7.8	30.2 ± 7.4	0.91
SOFA score, mean ± SD	14.9 ± 3.7	12.5 ± 4.5	15.4 ± 3.3	0.02	13.9 ± 3.7	15.3 ± 3.7	0.1
SOFA renal sub-score	2.2 ± 1.4	2.0 ± 1.7	2.3 ± 1.3	0.52	1.7 ± 1.4	2.5 ± 1.3	0.06
SBP, N (%)	19 (31.1)	7 (63.6)	12 (24.0)	0.03	5 (27.8)	14 (32.6)	0.71
Encephalopathy, N (%)	42 (68.9)	4 (36.4)	38 (76.0)	0.03	11 (61.1)	31 (72.1)	0.28
Ascites, N (%)	58 (95.1)	11 (100)	47 (94.0)	0.05	16 (88.9)	42 (97.7)	0.26
Mechanically ventilated, N (%)	51 (83.6)	6 (54.5)	45 (90.0)	0.01	16 (88.9)	35 (81.4)	0.71
PaO₂/FiO₂ ratio (mmHg), mean ± SD	252 ± 141	261 ± 129	250 ± 144	0.83	194 ± 117	277 ± 144	0.04
Norepinephrine dose at inclusion (μg/kg/min), mean ± SD	0.35 ± 0.35	0.20 ± 0.29	0.39 ± 0.35	0.11	0.26 ± 0.34	0.39 ± 0.35	0.21
Creatinine^b (μmol/l), mean ± SD	289 ± 165	299 ± 176	286 ± 165	0.81	239 ± 147	309 ± 170	0.13
INR, mean ± SD	2.8 ± 1.4	2.6 ± 1.5	2.8 ± 1.4	0.71	2.4 ± 0.7	2.9 ± 1.6	0.08
Bilirubin^b (μmol/l), mean ± SD	340.3 ± 284.3	146.0 ± 193.5	383.1 ± 284.6	0.01	313.3 ± 305.2	351.7 ± 278.1	0.63
Ammonia^b (μmol/l), mean ± SD	110.2 ± 101.1	74.7 ± 41.1	118.0 ± 108.8	0.03	111.6 ± 167.2	109.6 ± 57.4	0.96
Albumin (g/l), mean ± SD	32.5 ± 7.1	33.8 ± 8.1	32.2 ± 6.9	0.50	31.5 ± 5.4	32.9 ± 7.7	0.48
Hemoglobin (g/dl), mean ± SD	8.6 ± 1.6	9.4 ± 1.6	8.4 ± 1.6	0.27	8.3 ± 1.5	8.7 ± 1.6	0.42
Lactate level^b (mmol/l), mean ± SD	4.4 ± 4.3	3.7 ± 4.6	4.5 ± 4.2	0.59	2.9 ± 2.2	5.0 ± 4.8	0.02
Fluid intake in day 1 (ml), mean ± SD	4,356 ± 2,574	3,993 ± 1,877	4,436 ± 2,712	0.61	4,015 ± 2,486	4,499 ± 3,336	0.51
Fluid balance in day 1 (ml), mean ± SD	3,177 ± 2,919	1,544 ± 2,980	3,537 ± 4,335	0.04	2,368 ± 2,913	3,516 ± 2,887	0.16
MAP day 1 (mmHg), mean ± SD	70.7 ± 7.2	58.8 ± 5.8	59.4 ± 8.1	0.83	63.3 ± 7.1	57.6 ± 7.3	0.007
CVP day 1 (mmHg), mean ± SD	15.5 ± 6.2	12.3 ± 4.0	16.2 ± 6.4	0.054	14.1 ± 6.5	16.1 ± 6.1	0.28
IAP day 1 (mmHg), mean ± SD	15.3 ± 4.7	9.0 ± 2.2	16.7 ± 3.9	< 0.0001	12.8 ± 3.8	16.3 ± 4.7	0.008
APP day 1 (mmHg), mean ± SD	55.5 ± 7.7	59.4 ± 6.2	54.6 ± 7.8	0.06	64.7 ± 5.4	51.6 ± 4.7	< 0.0001
Randomization, N (%)
Hydrocortisone	32 (52.5)	4 (36.4)	28 (56.0)	0.24	14 (77.8)	18 (41.9)	0.01
Placebo	29 (47.5)	7 (63.6)	22 (44.0)		4 (22.2)	25 (58.1)

IAP ≥ 12 mmHg indicates intra-abdominal hypertension, and APP < 60 mmHg indicates abdominal hypoperfusion. IAP, intra-abdominal pressure; APP, abdominal perfusion pressure; SD, standard deviation; APACHE, Acute Physiology and Chronic Health Evaluation; SOFA, Sequential Organ Failure Assessment; SBP, spontaneous bacterial peritonitis; MAP, mean arterial pressure; CVP, central venous pressure; INR, international normalized ratio; PaO₂/FiO₂, the ratio of the partial pressure of arterial oxygen (PaO₂) to the fraction of inspired oxygen (FiO₂). ^aMean values on the first ICU day. ^bTo convert creatinine to mg/dl, divide by 88.4; bilirubin to mg/dl, divide by 17.1; ammonia to μg/dl, divide by 0.587; lactic acid to mg/dl, divide by 0.111.

Back to article page