Risk factors of postoperative intra-abdominal hypertension and the value of continuous dynamic intra-abdominal pressure monitoring in patients with abdominal trauma and retroperitoneal tumors
10.3760/cma.j.cn113855-20250821-00416
- VernacularTitle:腹部创伤与腹膜后肿瘤患者术后腹内压升高的危险因素及持续动态腹内压监测的价值
- Author:
Zishuo PEI
1
;
Mengmeng XIAO
;
Feifei JIN
;
Tianbing WANG
Author Information
1. 北京大学人民医院创伤救治中心 创伤救治与神经再生教育部重点实验室 国家创伤 医学中心，北京 100044
- Publication Type:Journal Article
- Keywords:
Wound and injuries;
Retroperitoneal neoplasms;
Intra-abdominal hypertension;
Risk factors;
Continuous dynamic intra-abdominal pressure monitoring
- From:
Chinese Journal of General Surgery
2025;40(11):850-855
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors for postoperative intra-abdominal pressure(IAP) elevation in patients with abdominal trauma and retroperitoneal tumors, and to evaluate the clinical value of continuous dynamic IAP monitoring.Methods:A total of 196 patients with abdominal trauma or retroperitoneal tumors admitted at Peking University People's Hospital from April 2024 to April 2025 were retrospectively enrolled. Postoperative IAP monitoring data were collected, and risk factors for IAP elevation were analyzed.Results:Postoperative IAP in patients with abdominal trauma and retroperitoneal tumors exhibited a peak-shaped pattern, reaching its maximum at 24 hours and returning to baseline by 72 hours. In both the abdominal trauma and retroperitoneal tumor groups, patients with poor outcomes showed significantly higher IAP peak values, longer durations of intra-abdominal hypertension (IAH), higher incidences of IAP>12 mmHg at 6 and 24 hours postoperatively, and longer durations of abdominal perfusion pressure (APP)<60 mmHg ( P<0.05).Multivariate analysis revealed that injury severity score (ISS)≥25, shock index≥1.0, and intraoperative blood transfusion≥2 000 ml were independent risk factors for IAP elevation in patients with abdominal trauma. In patients with retroperitoneal tumors, tumor diameter≥10 cm, intraoperative blood loss≥1 500 ml, peritoneal defect area≥20 cm2, and BMI≥28 kg/m2 were identified as significant risk factors for postoperative IAP elevation. Conclusions:Postoperative IAP in patients with abdominal trauma and retroperitoneal tumors exhibits a similar common dynamic pattern. Continuous dynamic monitoring of IAP can facilitate early identification of high-risk patients, with IAP>12 mmHg at 24 hours postoperatively showing the highest predictive value for adverse outcomes. For such patients, it is recommended to implement goal-directed monitoring for 72 hours to improve clinical prognosis.
