• Adrian Regli, Reintam BlaserAnnikaADepartment of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia; Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland., Bart De Keulenaer, Joel Starkopf, Edward Kimball, MalbrainManu L N GMLNGFaculty of Engineering, Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel (VUB), Brussels, Belgium; International Fluid Academy, Lovenjoel, Belgium., Peter Vernon Van Heerden, Wendy A Davis, IROI Study Investigators, Annamaria Palermo, Wojciech Dabrowski, Dorota Siwicka-Gieroba, Malgorzata Barud, Ioana Grigoras, Anca Irina Ristescu, Adina Blejusca, Kadri Tamme, Liivi Maddison, Ülle Kirsimägi, Andrey Litvin, Anastasiya Kazlova, Aliaksandr Filatau, Francisco Pracca, Gustavo Sosa, Maicol Dos Santos, Mikhail Kirov, Alexey Smetkin, Yana Ilyina, Daniel Gilsdorf, Carlos A Ordoñez, Yaset Caicedo, Patrick Greiffenstein, Margaret M Morgan, Zsolt Bodnar, Edit Tidrenczel, Gina Oliveira, Ana Albuquerque, and Bruno M Pereira.
• Department of Intensive Care, Fiona Stanley Hospital, Perth, WA, Australia; Medical School, The Notre Dame University, Fremantle, WA, Australia; Medical School, The University of Western Australia, Perth, WA, Australia. Electronic address: adrian.regli@health.wa.gov.
• J Crit Care. 2021 Aug 1; 64: 165-172.

PurposeTo assess whether the combination of intra-abdominal hypertension (IAH, intra-abdominal pressure ≥ 12 mmHg) and hypoxic respiratory failure (HRF, PaO2/FiO2 ratio < 300 mmHg) in patients receiving invasive ventilation is an independent risk factor for 90- and 28-day mortality as well as ICU- and ventilation-free days.MethodsMechanically ventilated patients who had blood gas analyses performed and intra-abdominal pressure measured, were included from a prospective cohort. Subgroups were defined by the absence (Group 1) or the presence of either IAH (Group 2) or HRF (Group 3) or both (Group 4). Mixed-effects regression analysis was performed.ResultsNinety-day mortality increased from 16% (Group 1, n = 50) to 30% (Group 2, n = 20) and 27% (Group 3, n = 100) to 49% (Group 4, n = 142), log-rank test p < 0.001. The combination of IAH and HRF was associated with increased 90- and 28-day mortality as well as with fewer ICU- and ventilation-free days. The association with 90-day mortality was no longer present after adjustment for independent variables. However, the association with 28-day mortality, ICU- and ventilation-free days persisted after adjusting for independent variables.ConclusionsIn our sub-analysis, the combination of IAH and HRF was not independently associated with 90-day mortality but independently increased the odds of 28-day mortality, and reduced the number of ICU- and ventilation-free days.Copyright © 2021 Elsevier Inc. All rights reserved.

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