Intrabdominal pressure and its correction in acute surgical pathology

Abstract

The aim: Improving the results of treatment of patients with acute surgical pathology of the abdominal cavity by correcting intra-abdominal hypertension (IAH). Materials and methods: The results of examination and treatment of 187 patients with acute surgical pathology, which was accompanied by elevation of IAP. To compare the results, depending on the chosen diagnostic and treatment tactics, patients were divided into two groups: comparison and main. The comparison group (85 people (45,5%) included patients who have been treated with traditional approaches in diagnosis and treatment according to existing treatment protocols. The main group (102 people (54,5%) included patients in whose treatment we additionally used our proposed step-by-step approach in the treatment of IAH. Results: Systemic complications occurred in 12 patients of the main group (11,8%) and in 46 patients of the comparison group (54,1%), while in the second group the frequency of systemic complications was significantly higher (χ2 = 38,6, CI 29,3-53,6, p <0,0001). 20 patients (10,7%) died (2 patients of the main group (1,96%) and 18 patients of the comparison group (21,2%) (χ2 = 17,85, CI 10,4-29,18, p <0,0001). Conclusions: Use in the complex treatment of patients with acute surgical pathology of the abdominal cavity, accompanied by IAH, the proposed step-by-step approach has improved treatment outcomes by reducing the incidence of systemic complications from 54,1% to 11,8%, total mortality from 21,2% to 1,96% and postoperative mortality - from 22,4% to 2,4%.