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PUBLISHED DATE: - 30-11-2024
https://doi.org/10.37547/TAJMSPR/Volume06Issue11-05
PAGE NO.: - 23-34
EVALUATION OF HEMODYNAMIC CHANGES
IN PATIENTS WITH URGENT SURGICAL
PATHOLOGY IN MILITARY MEDICINE
Farida Azizova
Center for Development of Professional Qualification of Medical Workers,
Tashkent, Uzbekistan
INTRODUCTION
Acute diseases of the abdominal organs are often
accompanied by the development of severe
complications, including multiple organ failure, the
cause of which in 97% of cases is intra-abdominal
hypertension (IAH) (1,4,3,9).
The problem of IAH has attracted the interest of
surgeons, who have identified a relationship
between the tension of the anterior abdominal wall
and the degree of respiratory failure (2,5,7). Many
studies have been conducted on the negative effect
of IAH on central and intracardiac hemodynamics.
It was obvious that an increase in IAH leads to an
increase in patient mortality [6,8,10].
Perioperative cardiac hemodynamic disturbances
and acute coronary events (ACS) are serious
complications in patients with emergency
abdominal surgery and trauma, especially in the
setting of IAH. Timely diagnosis of such disorders
plays an important role in preventing serious
consequences. One of the main tools for early
diagnosis of cardiovascular disorders is a non-
invasive study - echocardiography (EchoCG),
which allows you to assess the functional and
structural changes in the heart, as well as identify
signs of myocardial ischemia at early stages.
Aim of the study
. To study hemodynamic changes
in patients with urgent surgical pathology in
RESEARCH ARTICLE
Open Access
Abstract
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military medicine depending on the presence of
intra-abdominal hypertension
Research material
. A comparison of the results of
the study was conducted between military and
civilians with acute surgical abdominal pathology
depending on the presence of intra-abdominal
hypertension.
Table 1.
Distribution of patients into groups and subgroups
bygroup
A subgroup,
In the subgroup
total
patients with IAH
patients without IAH
groups
n
%
n
%
n
%
MG - main group,
patients are military
personnel
39
34,8%
73
65,2%
112
48,3%
CG comparison
group, civilian
patients
49
40,8%
71
59,2%
120
51,7%
Note: IAH intra-abdominal hypertension
A study was conducted on 232 patients with
emergency surgical diseases and abdominal
injuries who were treated at the intensive care unit
of the Republican Scientific Center for Emergency
Medical Care of the Ministry of Health of the
Republic of Uzbekistan and at the Military Hospital
of the Ministry of Health of the Republic of
Uzbekistan in the period from 2021 to 2024. The
main group (MG) consisted of 112 military patients
(48.3%), in this group subgroup A consisted of 39
patients
(34.8%)
with
intra-abdominal
hypertension (IAH+), subgroup B - 73 (65.2%)
without intra-abdominal hypertension (IAH-)
(Table 1). The comparison group (CG) consisted of
120 civilian patients (51.7%). Subgroup A CG
consisted of patients with IAH 49 patients (40.8%
of the number of CG patients), subgroup B-CG -
consisted of 71 patients (59.2%) (Table 1).
METHODS
Blood pressure monitoring, ECG monitoring,
echocardiographic examination, ultrasound of
abdominal organs, measurement of intra-
abdominal pressure with a Faley catheter
according to the S.E. Bradley and G.P. Bradley
method, statistical processing of results.
RESULTS
The conducted study of hemodynamic parameters
in patients of both subgroups with IAP+ and IAP -
demonstrated significant differences between
groups and subgroups.
Table 2 presents the results of a comparative
analysis of hemodynamic parameters in patients
with elevated and normal intra-abdominal
pressure (IAP) in two groups: civilian patients and
military personnel.
In the subgroup A CG, the heart rate was 95.2 ±
10.3 bpm, which was significantly higher than in
the subgroup B-CG - 78.4 ± 6.5 bpm. Similarly, in
the comparison group among military personnel,
the subgroup A-MG had a rate of 88.7 ± 8.2 bpm,
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while the subgroup B-MG had 75.6 ± 5.4 bpm. All
these differences were statistically significant with
a p-value < 0.001. In the A-CG subgroup, systolic
blood pressure was 150.3 ± 12.5 mmHg, which
significantly exceeded 130.1 ± 9.6 mmHg in
patients in the B-MG subgroup. In the A-MG
subgroup, SBP was 140.6 ± 10.8 mmHg compared
with 125.4 ± 7.3 mmHg in the B-MG subgroup. All
results were also statistically significant (p <
0.001). The diastolic pressure in the A-CG
subgroup was 95.1 ± 8.4 mm Hg versus 85.2 ± 6.8
mm Hg in the B subgroup. In the A-MG subgroup,
the DBP was 90.5 ± 7.5 mm Hg, while in the B-MG
subgroup it was 80.3 ± 5.9 mm Hg. These
differences are also statistically significant (p <
0.001) (Table 2).
Table 2.
Comparative analysis of hemodynamic parameters
Parameter
Subgroup A
MG (n=39)
Subgroup В
MG (n=73)
Subgroup А
CG (n=49)
Subgroup
В CG
(n=71)
Heart rate (bpm)
88.7 ± 8.2
75.6 ± 5.4
95.2 ± 10.3
78.4 ± 6.5
Systolic blood pressure
(mmHg)
140.6 ± 10.8
125.4 ± 7.3
150.3 ± 12.5
130.1 ± 9.6
Diastolic blood pressure
(mmHg)
90.5 ± 7.5
80.3 ± 5.9
95.1 ± 8.4
85.2 ± 6.8
Central venous pressure
(mmHg)
10.1 ± 1.9
7.8 ± 1.2
12.6 ± 2.0
8.3 ± 1.5
Blood oxygen level (%)
92.1 ± 3.5
96.3 ± 2.0
90.3 ± 3.8
95.2 ± 2.1
The central venous pressure in subgroup A-CG is
12.6 ± 2.0 mmHg, which is significantly higher than
in patients of subgroup B- CG (8.3 ± 1.5 mmHg). In
military personnel, similar indicators are: 10.1 ±
1.9 mmHg in subgroup A with IAH and 7.8 ± 1.2
mmHg in subgroup B without IAH, with a reliability
of p < 0.001. The blood oxygen level in civilian
patients with IAH is 90.3 ± 3.8%, while in patients
without IAH it is 95.2 ± 2.1%. In the group of
military personnel, subgroup A with VBH showed
an oxygen level of 92.1 ± 3.5%, which is lower than
that of subgroup B (96.3 ± 2.0%). All differences
are also statistically significant (p < 0.001).
ECG monitoring was carried out throughout the
entire observation period, with an emphasis on
identifying the following changes (Table 3). As can
be seen from Table 10, in subgroup A CG, normal
rhythm is observed in 36.7%, which is significantly
lower than in subgroup B (76.1%). This indicates a
high prevalence of rhythm disturbances in patients
with increased IAP.
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Table 3.
Results of ECG monitoring in examined patients
Parameter
Subgroup А
MG (n=39)
Subgroup В
MG (n=73)
Subgroup А
CG (n=49)
Subgroup В
CG (n=71)
Normal rhythm
20 (51,3%)
55 (75,3%)
18 (36,7%)
54 (76,1%)
Rhythm disturbances
20 (51,3%)
8 (11,0%)
19 (38,8%)
5 (7,0%)
Ischemic changes
10 (25,6%)
3 (4,1%)
24 (49,0%)
7 (9,9%)
Myocardial hypertrophy
5 (12,8%)
2 (2,7%)
8 (16,3%)
3 (4,2%)
Other pathologies
3 (7,7%)
1 (1,4%)
5 (10,2%)
1 (1,4%)
A significant proportion of patients with IAH in the
main group (51.3%) have rhythm disturbances,
which requires active monitoring and treatment
adjustment. Arrhythmia was more often observed
in military personnel against the background of
IAH - the frequency of rhythm disturbances was
53.3%. All differences are also statistically
significant (p < 0.05). Ischemic changes in the ECG
are observed more often in the CG, for example, in
the A-CG subgroup in 49.0% of patients, which
emphasizes the seriousness of their condition. In
the subgroup of military personnel without IAH,
ischemic changes are detected only in 9.9%. In
patients in the A-CG subgroup (16.3%), signs of
myocardial hypertrophy are observed, which may
indicate chronic cardiac overload.
The following parameters were assessed during
echocardiography (Table 4). In the comparison
group, the ejection fraction in patients with IAH
(50.5 ± 5.2%) was significantly lower than in
patients without IAH (60.1 ± 4.5%), indicating
worsening of systolic cardiac function with
increased IAP. The end-diastolic volume (EDV) in
patients with IAH was higher (85.0 ± 10.0 ml)
compared to patients without IAH (75.0 ± 9.0 ml).
Table 4.
Results of echocardiography parameters in the examined patients
Parameter
Subgroup А
MG(n=39)
Subgroup В
MG (n=73)
Subgroup А
CG (n=49)
Subgroup В
CG (n=71)
Ejection fraction
(EF) (%)
55.8 ± 4.9
63.0 ± 5.1
50.5 ± 5.2
60.1 ± 4.5
End diastolic
volume (EDV) (ml)
78.0 ± 8.5
70.0 ± 7.0
85.0 ± 10.0
75.0 ± 9.0
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End systolic volume
(ESV) (ml)
35.0 ± 6.5
25.0 ± 5.5
40.0 ± 8.0
30.0 ± 7.0
Left ventricular
diastolic pressure
(mmHg)
10.0 ± 2.5
6.0 ± 1.5
12.0 ± 3.0
8.0 ± 2.0
Maximum mitral
flow velocity (m/s)
1.0 ± 0.2
0.7 ± 0.1
1.2 ± 0.2
0.8 ± 0.1
Similarly, the end-systolic volume (ESV) in
patients with IAH is 40.0 ± 8.0 mL, which also
indicates impaired normal cardiac function. In
patients with IAH, the left ventricular diastolic
pressure is higher (12.0 ± 3.0 mmHg) compared to
patients without IAH (8.0 ± 2.0 mmHg), which may
indicate increased cardiac preload. The peak mitral
flow velocity in patients with IAH (1.2 ± 0.2 m/s) is
also higher than in patients without IAH (0.8 ± 0.1
m/s), which may indicate impaired diastolic
function.
The graph in Figure 1 shows the cardiac output
(CO) values in patients from different groups. In
patients with intra-abdominal hypertension
(IAH+) in the CG, the CO was 5.5 l/min. In patients
without IAH in the CG, this value increases to 6.7
l/min. In the MG, in servicemen with IAH, the CO is
5.9 l/min, and in patients without IAH, it is 7.2
l/min. Thus, patients with IAH have lower CO
values compared to those with normal abdominal
pressure.
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Figure 2 shows the cardiac index (CI) in the
examined patients: In the SS with IAH, the CI was
2.9 L/min/m², indicating insufficient cardiac
efficiency. In the CG without IAH, this indicator
increased to 3.4 L/min/m². In the MG group with
IAH, the CI is 3.2 L/min/m², while in patients
without IAH, this indicator reaches 3.7 L/min/m².
Patients with IAH demonstrate a lower cardiac
index, indicating a decrease in the heart's ability to
effectively pump blood.
Figure 3 shows the total vascular resistance
(TPVR): In civilian patients with IAH, the TVR was
150 mmHg, indicating a high load on the
cardiovascular system.
In civilian patients without IAH, this indicator
decreased to 120 mm Hg. In the group of military
personnel with IAH, the TPVR was 140 mm Hg, and
without IAH - 110 mm Hg. High TPVR values in
patients with IAH confirm increased resistance to
blood flow, which can negatively affect
cardiovascular function.
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The diastolic function of the LV was assessed in
groups depending on the presence of IAH (Table
5). In the MG with IAH, the value is 0.85 m/s, which
is lower than in civilian patients without IAH (1.00
m/s). In the CG with IAH, this indicator is 0.80 m/s,
and without IAH it reaches 1.10 m/s. These data
indicate a deterioration in diastolic function in
patients with IAH (Table 4.4). The value in the MG
with IAH is 0.50 m/s, while in the MG without IAH
it is 0.30 m/s. In the CG with IAH, the value is 0.60
m/s, and without IAH - 0.40 m/s. This also
indicates a violation of the diastolic function.
In MG with IAH, the E/A ratio is 1.70, which is
significantly lower than without IAH (3.33). CG
with IAH has a ratio of 1.33, while in without IAH
this figure is 2.75. A decreased E/A ratio indicates
diastolic dysfunction. In MG with IAH, diastolic
pressure is 10 mmHg, while in MG without IAH it is
8 mmHg. CG with IAH has a higher pressure of 12
mmHg compared to 9 mmHg in CG without IAH.
This confirms the presence of left ventricular
overload. Pulse pressure in MG with IAH is 50
mmHg, which is higher than in without IAH (40
mmHg).
Table 5.
Indicators of diastolic function of the left ventricle
Parameter
MG with IAH
(n=39)
MG without
IAH (n=73)
CG with IAH
(n=49)
CG without
IAH (n=71)
E (m/s)
0.85 ± 0.10
1.00 ± 0.12
0.80 ± 0.09
1.10 ± 0.14
A (m/s)
0.50 ± 0.08
0.30 ± 0.05
0.60 ± 0.07
0.40 ± 0.06
E/A
1.70 ± 0.15
3.33 ± 0.25
1.33 ± 0.12
2.75 ± 0.20
LV pressure
(mmHg)
10 ± 2
8 ± 1
12 ± 3
9 ± 2
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Pulse pressure
(mmHg)
50 ± 5
40 ± 4
55 ± 6
35 ± 5
In CG with IAH, a pulse pressure of 55 mm Hg is
demonstrated, while without IAH this indicator is
35 mm Hg (Table 4.4). Increased pulse pressure
may be associated with an increase in total
peripheral resistance.
The study showed that cardiac remodeling in IAP+
is characterized by both concentric hypertrophy
and eccentric hypertrophy of the left ventricle.
Concentric hypertrophy was detected in 52% of CG
patients with IAP+, which is associated with an
increase in afterload and myocardial adaptation to
increased resistance. This type of remodeling leads
to thickening of the left ventricular walls without a
significant increase in its volume.
Eccentric hypertrophy was detected in 36% of CG
patients with IAP+, which was characterized by an
increase in the volume of the left ventricular cavity
with a relatively normal thickness of its walls. This
type of remodeling was more common in patients
with chronically increased IAP and was associated
with worsening diastolic function and a decrease
in ejection fraction.
Figure 4. Types of remodeling of the right and left
chambers of the heart in patients with intra-
abdominal hypertension CG.
Diastolic dysfunction of the right and left ventricles
is a common feature of cardiac remodeling in IAH+.
Left ventricular diastolic dysfunction, expressed as
an abnormal E/A ratio and decreased myocardial
relaxation, is noted in 65% of MG patients with
IABG+. The right ventricle also shows signs of
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diastolic dysfunction in 42% of MG patients with
elevated IAP.
Figure 4 shows the types of right and left heart
remodeling in HS patients with intra-abdominal
hypertension (IAH). It is evident that the most
common changes are left ventricular diastolic
dysfunction (65%) and left ventricular concentric
hypertrophy (52%). Also, a significant number of
patients demonstrate right ventricular dilation
(48%) and left ventricular eccentric hypertrophy
(36%). These data highlight how IAH affects
cardiac structures, causing adaptive changes in the
right and left heart.
Table6.
Troponin I, CPK-MB and LDH levels
Subgroup
Troponin I (M ±
σ, ng/ml)
CPK-MB (M ± σ,
U/L)
LDH (M ± σ,
U/L)
А-MG
0.20 ± 0.10
190 ± 18
410 ± 45
В-MG
0.09 ± 0.04
140 ± 15
350 ± 40
А-CG
0.38 ± 0.12
250 ± 25
470 ± 50
В-CG
0.18 ± 0.09
180 ± 17
400 ± 42
The levels of cardiac-specific enzymes in CG
patients with IAH+ (subgroup A CG) were
significantly higher compared to patients from the
comparison group, indicating a high risk of
myocardial infarction (Table 6). Troponin I: In
subgroup A CG
—
0.38 ± 0.12 ng/ml. In subgroup
A MG
—
0.20 ± 0.10 ng/ml. In subgroup B CG
—
0.18 ± 0.09 ng/ml. In subgroup B MG
—
0.09 ± 0.04
ng/ml. CPK-MB: In subgroup A CG
—
250 ± 25 U/l.
In subgroup B MG
—
190 ± 18 U/l. In subgroup B
CG - 180 ± 17 U/L. In subgroup B MG - 140 ± 15
U/L. LDH: In subgroup A CG - 470 ± 50 U/L. In
subgroup A MG - 410 ± 45 U/L. In subgroup B CG -
400 ± 42 U/L. In subgroup B MG - 350 ± 40 U/L.
Among patients with elevated troponin I (> 0.2
ng/ml) and CPK-MB (> 200 U/L) levels, there was
an increased incidence of myocardial infarction.
Increased levels of cardiac-specific enzymes
significantly correlate with the development of
myocardial infarction in patients with acute
abdominal pathology, especially in the presence of
intra-abdominal hypertension and concomitant
cardiovascular pathology.
The results of the study also showed that an acute
increase in IAP causes more pronounced changes
in central and intracardiac hemodynamics
compared to a chronic increase in IAP, which was
diagnosed only in the CG. In acute IAP, the decrease
in cardiac output was 20%, while in chronic
increase, this figure was about 10%. This is due to
the fact that an acute increase in IAP leads to a
sharp disruption of venous return and an increase
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in afterload, which causes a significant decrease in
cardiac output and an increase in central venous
pressure.
The ejection fraction in patients with acute IAP
decreased to 42%, indicating a significant
impairment of cardiac contractility. In chronic IAP,
this figure remained at 48%, indicating smaller
changes caused by cardiac adaptation to increased
load. However, even in chronic IAP, signs of
diastolic dysfunction were noted, observed in 58%
of patients. Patients with chronic increase in IAP
show a smaller decrease in cardiac output
compared to patients with acute IAP, which is
associated with partial development of adaptive
mechanisms. Blood pressure in patients with acute
increase in IAP is often reduced due to a sharp
deterioration in systemic circulation, while
patients with chronic IAP have more stable
indicators. CVP increases with both acute and
chronic increases in IAP, but with an acute
increase, a more significant increase in CVP is
observed. The levels of cardiac-specific enzymes
(troponin I, CPK-MB) are increased in both
conditions, but with an acute increase in IAP, more
pronounced myocardial damage is observed
(Table 7). These data indicate greater myocardial
damage with an acute increase in IAP.
Table7.
Central and intracardiac hemodynamic parameters in acute and chronic increase
in IAP in CG
Indicator
Acute increase in
IAP (M ± σ)
Chronic increase in IAP
(M ± σ)
Cardiac output (L/min)
3,2 ± 0,6
4,0 ± 0,7
Blood pressure (mmHg)
93,5 ± 12,1
112,9 ± 10,7
CVP (mmHg)
16,7 ± 3,5
12,8 ± 2,4
Intra-abdominal hypertension has a negative
impact on the cardiovascular status of both
military personnel and civilians, but the degree of
this impact varies. Civilians with IAH+ have a
higher incidence of cardiovascular complications
(61.2%) than military personnel with IAH+
(51.3%). Military personnel with IAH+ have a
higher cardiac output (3.8±0.5 l/min) compared to
civilians (3.2±0.4 l/min), which may indicate more
effective compensatory mechanisms. Differences
in the mechanisms of complications may be
associated with age, physical fitness, and the
presence of concomitant pathology.
CONCLUSION
The study found that the main predictors of
cardiovascular complications in military personnel
with intra-abdominal hypertension include: intra-
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abdominal hypertension, which increases the risk
of cardiovascular complications by 2.5 times
compared to patients without intra-abdominal
hypertension. Elevated troponin I levels (>0.05
ng/ml), which is associated with a 35.0% increase
in the risk of complications, the presence of arterial
hypertension, which increases the risk of
complications by 25.0%. High BMI (≥28 kg/m²),
which is associated with a 20.0% increase in risk.
Decreased cardiac output (<4.0 l/min), which
increases the risk of complications by 18.0%.
Thus, acute increase in IAP is associated with a
sharp decrease in cardiac output, arterial
hypotension, and a more pronounced increase in
CVP. Elevated levels of cardiac-specific enzymes
indicate greater myocardial damage with acute
increase in IAP. Chronic increase in IAP is
accompanied by less pronounced hemodynamic
disturbances. Patients with chronic increase in IAP
have more stable blood pressure readings, a
smaller increase in CVP, and lower levels of
cardiac-specific enzymes, indicating partial
adaptation of the heart to increased IAP.
REFERENCES
1.
Abdominal compartment syndrome: modern
aspects of diagnosis and treatment / V.E. Korik,
D.A. Klyuiko, G.V. But-Gusaim, et al. // Military
medicine. - 2016. - No. 3. - P. 127-133.
2.
Akopyan R.V. Prognostic value of intra-
abdominal pressure monitoring in the
intensive care unit // Reports of the National
Academy of Sciences of the Republic of
Armenia. - 2009. - Vol. 109 (4). - P. 359-369.
3.
Intra-abdominal hypertension and abdominal
sepsis: what comes first? / V.F. Zubritsky, A.B.
Zemlyanoy, A.P. Koltovich, et al. // Medical
Bulletin of the Ministry of Internal Affairs. -
2016. - No. 2. - P. 21-25.
4.
Golbraikh, V.A. History of the study of the
syndrome of increased intra-abdominal
pressure and modern approaches to its
correction [Electronic resource] / V.A.
Golbraikh, D.S. Zemlyakov, I.A. Dubrovin //
Modern problems of science and education. -
2015. - No. 3.
5.
Lyamin, A.Yu. Monitoring intra-abdominal
pressure in patients with acute pancreatitis /
A.Yu. Lyamin, Yu.V. Nikiforov, V.V. Moroz /
General resuscitation. - 2006. - V. 2, No. 5-6. - P.
123-128.
6.
Mayorov, A.V. Diagnostic value of intra-
abdominal pressure in the treatment of
patients with acute colonic obstruction:
author's abstract. diss. doctor of medicine.
sciences: 14.01.17 / Mayorov Alexander
Vladimirovich. - Moscow, 2011. - 27 p.
7.
Matyushko,
D.N.
Intra-abdominal
hypertension and compartment syndrome:
literature review / D.N. Matyushko, E.I.
Turgunov, A. Zlotnik // Science and
Healthcare. - 2015. - No. 1.- P. 22-32.
8.
Mezentsev, E.N. The role of typological factor in
the level of intra-abdominal pressure in urgent
surgical practice [Electronic resource] / E.N.
Mezentsev, Yu.M. Shutov, A.S. Shchedrin //
Medicine and education in Siberia. - 2015. - No.
3.
9.
Mustafakulov,
I.B.
Intra-abdominal
hypertension syndrome in abdominal organ
injuries / I.B. Mustafakulov // Tyumen Medical
Journal. - 2014. -
№4.
- P. 59-60.
10.
Nikitina, E.V. Relationship between intra-
abdominal pressure and blood gas parameters,
acid-base balance and frequency of mechanical
ventilation in patients with acute destructive
pancreatitis / E.V. Nikitina, I.M. Samsonova //
Surgical news. - 2014. -
Vol. 22, №2.
- P. 213-
217.
THE USA JOURNALS
THE AMERICAN JOURNAL OF MEDICAL SCIENCES AND PHARMACEUTICAL RESEARCH
(ISSN
–
2689-1026)
VOLUME 06 ISSUE11
34
https://www.theamericanjournals.com/index.php/tajmspr
11.
Ovchinnikov, V.A. Abdominal compartment
syndrome / V.A. Ovchinnikov, V.A. Sokolov //
Modern technologies in medicine. - 2013. - Vol.
5, №1.
- P. 122-129.
