ORCID Profile
0000-0002-1816-5255
Current Organisation
Medical University of Lublin
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Publisher: Elsevier BV
Date: 08-2021
Publisher: Springer Science and Business Media LLC
Date: 08-07-2011
DOI: 10.1007/S00134-011-2298-X
Abstract: To investigate if femoral venous pressure (FVP) measurement can be used as a surrogate measure for intra-abdominal pressure (IAP) via the bladder. This was a prospective, multicenter observational study. IAP and FVP were simultaneously measured in 149 patients. The effect of BMI on IAP was investigated. The incidences of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) were 58 and 7% respectively. The mean APACHE II score was 22 ± 10, SAPS 2 score 42 ± 20, and SOFA score 9 ± 4. The mean IAP was 11.2 ± 4.5 mmHg versus 12.7 ± 4.7 mmHg for FVP. The bias and precision for all measurements were -1.5 and 3.6 mmHg respectively with the lower and upper limits of agreement being -8.6 and 5.7. When IAP was above 20 mmHg, the bias between IAP and FVP was 0.7 with a precision of 2.0 mmHg (lower and upper limits of agreement -3 and 4.6 respectively). Excluding those with ACS, according to the receiver operating curve analysis FVP = 11.5 mmHg predicted IAH with a sensitivity and specificity of 84.8 and 67.0% (AUC of 0.83 (95% CI 0.81-0.86) with P < 0.001). FVP = 14.5 mmHg predicted IAP above 20 mmHg with a sensitivity of 91.3% and specificity of 68.1% (AUC 0.85 (95% CI 0.79-0.91), P < 0.001). Finally, at study entry, the mean IAP in patients with a BMI less then 30 kg/m(2) was 10.6 ± 4.0 mmHg versus 13.8 ± 3.8 mmHg in patients with a BMI ≥ 30 kg/m(2) (P < 0.001). FVP cannot be used as a surrogate measure of IAP unless IAP is above 20 mmHg.
Publisher: Springer Science and Business Media LLC
Date: 2012
Publisher: Springer Science and Business Media LLC
Date: 04-04-2008
DOI: 10.1007/S00134-008-1098-4
Abstract: To investigate the effect of different reference transducer positions on intra-abdominal pressure (IAP) measurement. Three reference levels were studied: the symphysis pubis the phlebostatic axis and the midaxillary line at the level of the iliac crest. Prospective cohort study. The intensive care units of participating hospitals One hundred thirty-two critically ill patients at risk for intra-abdominal hypertension (IAH). In each patient, three sets of IAP measurements were obtained in the supine position, using the different reference levels. The IAP measurements obtained at the different reference levels were compared using a paired t-test and Bland-Altman statistics were calculated. IAP(phlebostatic) (9.9 +/- 4.67 mmHg) and IAP(pubis) (8.4 +/- 4.60 mmHg) were significantly lower that IAP(midax) (12.2 +/- 4.66 mmHg p < 0.0001 for both comparisons). The bias between the IAP(midax) and IAP(pubis) was 3.8 mmHg (95% CI 3.5-4.1) and 2.3 mmHg (95% CI 1.9-2.6) between the IAP(midax) and the IAP(phlebostatic). The precision was 3.03 and 3.40, respectively. In the supine position, IAP(midax) is higher than both IAP(phlebostatic) and IAP(pubis), differences found to be clinically significant therefore, the symphysis pubis or phlebostatic axis reference lines are not interchangeable with the midaxillary level.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2011
Publisher: Termedia Sp. z.o.o.
Date: 04-08-2014
Publisher: Termedia Sp. z.o.o.
Date: 22-06-2017
Publisher: Springer Science and Business Media LLC
Date: 12-09-2006
DOI: 10.1007/S00134-006-0349-5
Abstract: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have been increasingly recognized in the critically ill over the past decade. The variety of definitions proposed has led to confusion and difficulty in comparing one study to another. An international consensus group of critical care specialists convened at the second World Congress on Abdominal Compartment Syndrome to standardize definitions for IAH and ACS based upon the current understanding of the pathophysiology surrounding these two syndromes. Prior to the conference the authors developed a blueprint for the various definitions, which was further refined both during and after the conference. The present article serves as the final report of the 2004 International ACS Consensus Definitions Conference and is endorsed by the World Society of Abdominal Compartment Syndrome (WSACS). IAH is redefined as an intra-abdominal pressure (IAP) at or above 12 mmHg. ACS is redefined as an IAP above 20 mmHg with evidence of organ dysfunction/failure. ACS is further classified as either primary, secondary, or recurrent based upon the duration and cause of the IAH-induced organ failure. Standards for IAP monitoring are set forth to facilitate accuracy of IAP measurements from patient to patient. State-of-the-art definitions for IAH and ACS are proposed based upon current medical evidence as well as expert opinion. The WSACS recommends that these definitions be used for future clinical and basic science research. Specific guidelines and recommendations for clinical management of patients with IAH/ACS are published in a separate review.
Publisher: Termedia Sp. z.o.o.
Date: 29-12-2015
Publisher: Termedia Sp. z.o.o.
Date: 04-08-2014
Publisher: Wiley
Date: 23-10-2023
DOI: 10.1111/AAS.14345
Publisher: Springer Science and Business Media LLC
Date: 25-04-2019
Publisher: Wiley
Date: 26-12-2020
DOI: 10.1111/AAS.13519
Abstract: In patients with septic shock, mortality is high, and survivors experience long-term physical, mental and social impairments. The ongoing Conservative vs Liberal Approach to fluid therapy of Septic Shock in Intensive Care (CLASSIC) trial assesses the benefits and harms of a restrictive vs standard-care intravenous (IV) fluid therapy. The hypothesis is that IV fluid restriction improves patient-important long-term outcomes. To assess the predefined patient-important long-term outcomes in patients randomised into the CLASSIC trial. In this pre-planned follow-up study of the CLASSIC trial, we will assess all-cause mortality, health-related quality of life (HRQoL) and cognitive function 1 year after randomisation in the two intervention groups. The 1-year mortality will be collected from electronic patient records or central national registries in most participating countries. We will contact survivors and assess EuroQol 5-Dimension, -5-Level (EQ-5D-5L) and EuroQol-Visual Analogue Scale and Montreal Cognitive Assessment 5-minute protocol score. We will analyse mortality by logistic regression and use general linear models to assess HRQoL and cognitive function. With this pre-planned follow-up study of the CLASSIC trial, we will provide patient-important data on long-term survival, HRQoL and cognitive function of restrictive vs standard-care IV fluid therapy in patients with septic shock.
Publisher: Springer Science and Business Media LLC
Date: 06-02-2017
Publisher: Springer Science and Business Media LLC
Date: 22-03-2007
DOI: 10.1007/S00134-007-0592-4
Abstract: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have been increasingly recognized in the critically ill over the past decade. In the absence of consensus definitions and treatment guidelines the diagnosis and management of IAH and ACS remains variable from institution to institution. An international consensus group of multidisciplinary critical care specialists convened at the second World Congress on Abdominal Compartment Syndrome to develop practice guidelines for the diagnosis, management, and prevention of IAH and ACS. Prior to the conference the authors developed a blueprint for consensus definitions and treatment guidelines which were refined both during and after the conference. The present article is the second installment of the final report from the 2004 International ACS Consensus Definitions Conference and is endorsed by the World Society of the Abdominal Compartment Syndrome. The prevalence and etiological factors for IAH and ACS are reviewed. Evidence-based medicine treatment guidelines are presented to facilitate the diagnosis and management of IAH and ACS. Recommendations to guide future studies are proposed. These definitions, guidelines, and recommendations, based upon current best evidence and expert opinion are proposed to assist clinicians in the management of IAH and ACS as well as serve as a reference for future clinical and basic science research.
Publisher: Springer Science and Business Media LLC
Date: 15-05-2013
Publisher: Wiley
Date: 24-07-2019
DOI: 10.1111/AAS.13434
Abstract: Intravenous (IV) fluid is a key intervention in the management of septic shock. The benefits and harms of lower versus higher fluid volumes are unknown and thus clinical equipoise exists. We describe the protocol and detailed statistical analysis plan for the conservative versus liberal approach to fluid therapy of septic shock in the Intensive Care (CLASSIC) trial. The aim of the CLASSIC trial is to assess benefits and harms of IV fluid restriction versus standard care in adult intensive care unit (ICU) patients with septic shock. CLASSIC trial is an investigator-initiated, international, randomised, stratified, and analyst-blinded trial. We will allocate 1554 adult patients with septic shock, who are planned to be or are admitted to an ICU, to IV fluid restriction versus standard care. The primary outcome is mortality at day 90. Secondary outcomes are serious adverse events (SAEs), serious adverse reactions (SARs), days alive at day 90 without life support, days alive and out of the hospital at day 90 and mortality, health-related quality of life (HRQoL), and cognitive function at 1 year. We will conduct the statistical analyses according to a pre-defined statistical analysis plan, including three interim analyses. For the primary analysis, we will use logistic regression adjusted for the stratification variables comparing the two interventions in the intention-to-treat (ITT) population. The CLASSIC trial results will provide important evidence to guide clinicians' choice regarding the IV fluid therapy in adults with septic shock.
Publisher: SAGE Publications
Date: 11-2016
DOI: 10.1177/0310057X1604400604
Abstract: Intra-abdominal hypertension (IAH) is highly prevalent in critically ill patients admitted to the intensive care unit and is associated with an increased morbidity and mortality. The present study investigated whether femoral venous pressure (EVP) can be used as a surrogate parameter for intra-abdominal pressure (IAP) measured via the bladder in IAH grade II (IAP mmHg) or grade III (IAP ≥20 mmHg). This was a single-centre prospective study carried out in a tertiary adult intensive care unit. IAP was measured via the bladder with a urinary catheter with simultaneous recording of the FVP via a femoral central line. If the IAP was mmHg external weight to a maximum of 10 kg was applied to the abdomen with subsequent measurements of IAP and FVP. Eleven patients were enrolled into the study. IAH (IAP mmHg) was identified in five patients (42%) and abdominal compartment syndrome (ACS, IAP mmHg with new onset organ failure) in two (18%) with all-cause study mortality of 18%. The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 21 ± 5, Simplified Acute Physiology (SAPS 2) score 49 ± 8, and Sequential Organ Failure Assessment (SOFA) score 9 ± 3. At baseline the bias between IAP and FVP was 3.2 with a precision of 3.63 mmHg (limits of agreement [LA] −4.1, 10.4). At 5 kg and 10 kg, the bias was 2.5 with a precision of 3.92 mmHg (LA-5.4, 10.3) and 2.26 mmHg (LA-2.1, 7.0) respectively. A receiver operating characteristic analysis for FVP to predict IAH showed an area under the curve of 0.87 (95% confidence interval 0.74–0.94, P=0.0001). FVP cannot be recommended as a surrogate measure for IAP even at IAP values above 20 mmHg. However, an elevated FVP was a good predictor of IAH.
Publisher: Massachusetts Medical Society
Date: 22-01-2015
DOI: 10.1056/NEJMC1414731
Publisher: Oxford University Press (OUP)
Date: 13-06-2020
DOI: 10.1002/BJS.11746
Publisher: Massachusetts Medical Society
Date: 31-05-2012
Publisher: Springer Science and Business Media LLC
Date: 05-08-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2009
No related grants have been discovered for Manu Malbrain.