The effect of intra -abdominal pressure and abdominal perfusion pressure in patients with different level of kidney function in ICU

doi:10.3969/j.issn.1002-1949.2014.09.009

Abstract：Objective To discuss the effect of intra -abdominal pressure ( IAP) and abdominal perfusion pressure ( APP) in patients with different level of kidney function in ICU .Methods One hundred and twenty cases of ICU patients from May 2012 to September 2013 were selected and divided into abnormal renal function group (70 cases) and normal renal function group (50 cases) by the basis of renal function .The IAP and APP of the ICU patients were measured through monitoring the bladder pressures.At the same time, Logistic regression was used to analyze the correlative risk factors for acute renal failure ( ARF) .The IAP and APP critical value predicted ARF were obtained according to the ROC curve.Results The IAP of abnormal renal function group (17.54 ±5.58) mm Hg was higher than that of normal group;the APP of abnormal renal function group (65.45 ±11.60)mm Hg was lower than normal group; comparative differences between two groups are of statistical significance ( P <0.05).The incidence of ARF in abnormal renal function group was 40.28%, significantly higher than that in the normal group (P<0.01).Logistic regression analysis shows that body position , APACHEⅡscore, SOFA score, vascular active drug use history , IAP, APP were independent risk factors for the occurrence of ARF .According to the ROC curve analysis , the IAP and APP critical value predicted ARF were 21.64 mm Hg and 55.80 mm Hg, respectively.Conclusion The IAP and APP in ICU patients are of great individual difference .The body position , APACHEⅡ score, SOFA score, vascular active drug use history , IAP and APP are the risk factors in patients with ARF;IAP and the APP can be usedas key indicators to predict ARF occurrence in ICU patients , especially in patients with abnormal renal function.