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Abdominal Perfusion Pressure in Critically Ill Cirrhotic Patients: a Prospective Observational Study

2023Journal article Open access
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dc.contributor.authorAntunes Pereira, R
dc.contributor.authorEsteves, A
dc.contributor.authorSousa Cardoso, F
dc.contributor.authorPerdigoto, R
dc.contributor.authorMarcelino, P
dc.contributor.authorSaliba, F
dc.date.accessioned2024-08-07T14:49:06Z
dc.date.available2024-08-07T14:49:06Z
dc.date.issued2023
dc.description.abstractIn critical patients, abdominal perfusion pressure (APP) has been shown to correlate with outcome. However, data from cirrhotic patients is scarce. We aimed to characterize APP in critically ill cirrhotic patients, analyze the prevalence and risk factors of abdominal hypoperfusion (AhP) and outcomes. A prospective cohort study in a general ICU specialized in liver disease at a tertiary hospital center recruited consecutive cirrhotic patients between October 2016 and December 2021. The study included 101 patients, with a mean age of 57.2 (± 10.4) years and a female gender proportion of 23.5%. The most frequent etiology of cirrhosis was alcohol (51.0%), and the precipitant event was infection (37.3%). ACLF grade (1-3) distribution was 8.9%, 26.7% and 52.5%, respectively. A total of 1274 measurements presented a mean APP of 63 (± 15) mmHg. Baseline AhP prevalence was 47%, independently associated with paracentesis (aOR 4.81, CI 95% 1.46-15.8, p = 0.01) and ACLF grade (aOR 2.41, CI 95% 1.20-4.85, p = 0.01). Similarly, AhP during the first week (64%) had baseline ACLF grade (aOR 2.09, CI 95% 1.29-3.39, p = 0.003) as a risk factor. Independent risk factors for 28-day mortality were bilirubin (aOR 1.10, CI 95% 1.04-1.16, p < 0.001) and SAPS II score (aOR 1.07, CI 95% 1.03-1.11, p = 0.001). There was a high prevalence of AhP in critical cirrhotic patients. Abdominal hypoperfusion was independently associated with higher ACLF grade and baseline paracentesis. Risk factors for 28-day mortality included clinical severity and total bilirubin. The prevention and treatment of AhP in the high-risk cirrhotic patient is prudential.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationSci Rep . 2023 May 26;13(1):8550.pt_PT
dc.identifier.doi10.1038/s41598-023-34367-6pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4974
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherNature Publishing Grouppt_PT
dc.subjectHSM UCIpt_PT
dc.subjectHCC UCIpt_PT
dc.subjectHCC CHBPTpt_PT
dc.subjectHumanspt_PT
dc.subjectFemalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectAcute-On-Chronic Liver Failure*pt_PT
dc.subjectBilirubinpt_PT
dc.subjectCritical Illness*pt_PT
dc.subjectLiver Cirrhosis / complicationspt_PT
dc.subjectLiver Cirrhosis / epidemiologypt_PT
dc.subjectPerfusionpt_PT
dc.subjectPrognosispt_PT
dc.subjectProspective Studiespt_PT
dc.titleAbdominal Perfusion Pressure in Critically Ill Cirrhotic Patients: a Prospective Observational Studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.startPage8550pt_PT
oaire.citation.titleScientific Reportspt_PT
oaire.citation.volume13pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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