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Author Notes:

Andrea Kurz, Email: ak@or.org

AKK: investigation, conceptualization, writing—review and editing. SM: investigation, writing—review and editing. AK: conceptualization, writing—review and editing. VM: investigation, conceptualization, writing- original draft preparation, writing—review and editing. KS: data curation, formal analysis, software, writing—review and editing. LE: data curation, formal analysis, writing—review and editing. AP: investigation, writing—review and editing.

The authors would like to thank the Predict AKI Group for their work and dedication to this study. Predict AKI Group Authors: Lynnette C. Harris, BSN lcharris@wakehealth.edu; Nia Sweatt, BS Nia.sweatt@gmail.com; Kelsey Flores, BS kflores@wakehealth.edu; Brandon Reeves, RN breeves@wakehealth.edu; Bruce Cusson, RN bcusson@wakehealth.edu; Lillian Nosow, BS lnosow@wakehealth.edu; Jessica Fanelli jfanelli@wakehealth.edu; Lauren Sands, BS sandslauren16@gmail.com; Jacob Fowler, BS jfowler347@gmail.com; Easton Howard, BS Easton.Howard96@gmail.com; Samuel Robinson, BS samrob14@gmail.com; Anthony Wachnik, BS aawachnik@gmail.com; Madeline Fram, BS mfram@wakehealth.edu; Rohesh Fernando, MD rfernan@wakehealth.edu; Chandrika Garner, MD crgarner@wakehealth.edu; Bryan Marchant, MD bmarchan@wakehealth.edu; Benjamin Morris, MD bmorris@wakehealth.edu; Amit Saha MS, PhD aksaha@wakehealth.edu; Katherine Egan, BSN, RN, CCRC kfegan@emory.edu; Bev Ann Blackwell, BS bblackwell@potreromed.com.

SM and AP declare no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work. AKK is a paid consultant for and chairs the steering committee for the Predict AKI group for Potrero Medical and also consults for Edwards Lifesciences, Philips North America, GE Healthcare, Hill-Rom, and Caretaker Medical. His institution has grant funding from Caretaker Medical for ongoing investigations on portable hemodynamic monitoring. AKK is on the executive advisory board for Medtronic and Retia Medical. AKK receives support from the Wake Forest CTSI via NIH/NCATS KL2 for a trial of continuous portable hemodynamic and saturation monitoring on hospital wards. AK is a member of the steering committee for the Predict AKI group for Potrero Medical. VM serves as Chief Medical Officer, KS as Vice President of Data Science, and LE is a data scientist for Potrero Medical, Hayward, CA, USA and are salaried employees. We acknowledge that Vanessa Moll, Kelly Stanton, and Leina Essakalli are employees of Potrero Medical. However, data analysis, as well as manuscript preparation, were led by authors who actively enrolled study patients. Furthermore, while the study was funded by Potrero Medical, this descriptive manuscript is not testing any hypothesis and there is no intervention involved that could potentially be influenced by bias. Dr. Khanna is a paid consultant for the steering committee of the registry; however, he did not directly consent or enroll any patients. Rather this was done at his site by members of his research staff.

Subject:

Research Funding:

This study was developed and is funded by Potrero Medical, Hayward, and is part of a larger global, multicenter registry trial.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Anesthesiology
  • Intra-abdominal pressure
  • IAP
  • Intra-abdominal hypertension
  • IAH
  • Cardiac surgery
  • Perioperative
  • Abdominal compartment syndrome
  • Real-time monitoring
  • ABDOMINAL PERFUSION-PRESSURE
  • ACUTE KIDNEY INJURY
  • URINE OUTPUT
  • COMPARTMENT
  • SOCIETY
  • RISK

Intra-abdominal hypertension in cardiac surgery patients: a multicenter observational sub-study of the Accuryn registry

Tools:

Journal Title:

JOURNAL OF CLINICAL MONITORING AND COMPUTING

Volume:

Volume 37, Number 1

Publisher:

, Pages 189-199

Type of Work:

Article | Final Publisher PDF

Abstract:

Intra-abdominal hypertension (IAH) is frequently present in the critically ill and is associated with increased morbidity and mortality. Conventionally, intermittent ‘spot-check’ manual measurements of bladder pressure in those perceived as high risk are used as surrogates for intra-abdominal pressure (IAP). True patterns of IAH remain unknown. We explored the incidence of IAH in cardiac surgery patients and describe the intra-and postoperative course of IAP using a novel, high frequency, automated bladder pressure measurement system. Sub-analysis of a prospective, multicenter, observational study (NCT04669548) conducted in three large academic medical centers. Continuous urinary output (CUO) and IAP measurements were observed using the Accuryn Monitoring System (Potrero Medical, Hayward, CA). Data collected included demographics, hemodynamic support, and high-frequency IAP and CUO. One Hundred Thirty-Seven cardiac surgery patients were analyzed intraoperatively and followed 48 h postoperatively in the intensive care unit. Median age was 66.4 [58.3, 72.0] years, and 61% were men. Median Foley catheter dwell time was 56.0 [46.8, 77.5] hours, and median baseline IAP was 6.3 [4.0, 8.1] mmHg. 93% (128/137) of patients were in IAH grade I, 82% (113/137) in grade II, 39% (53/137) in grade III, and 5% (7/137) in grade IV for at least 12 cumulative hours. For maximum consecutive duration of IAH, 84% (115/137) of patients spent at least 12 h in grade I, 62% (85/137) in grade II, 18% (25/137) in grade III, and 2% (3/137) in grade IV IAH. During the first 48 h after cardiac surgery, IAH is common and persistent. Improved and automated monitoring of IAP will increase the detection of IAH—which normally would remain undetected using traditional intermittent monitoring methods.

Copyright information:

© The Author(s) 2022

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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