ABDOMINAL PERFUSION PRESSURE IN PREDICTION OF THE TERMS OF ACUTE NECROTIZING PANCREATITIS INFECTION

Abstract

The aim: To determine the role of the abdominal perfusion pressure level at the beginning of the disease in predicting the timing of infection of acute nec¬rotizing pancreatitis. Materials and methods: A retrospective cross-sectional single-center study of 39 patients with acute severe pancreatitis (ASP) and pancreatic infection (PI) with measured and calculated minimal abdominal perfusion pressure (APP) in the first 48 hours of the disease. The existence of a correlation between the onset of PI and the level of intra-abdominal (IAP) and abdominal perfusion pressure was calculated and a single-factor mathematical model of linear regression was built. Results: A negative strong correlation was found between IAP and the timing of PI onset, ρ=-0.818 (p<0.001), and a positive strong correlation was found between APP and the timing of PI onset, ρ=0.933 (p<0.001). The dependence of the outcome variable (PI term) on the APP value was revealed, adjusted coefficient of determination R²adj = 0.887 was corrected, F value 288.5, p<0.001, root mean square errors RSE = 1.31 (with 37 degrees of freedom). The value of the coefficient X1 was 0.47±0.0, p<0.001. Conclusions: An increase in IAP in the first 48 hours of the desease in patients with ASP was, on average, accompanied by a reduction in the start of PI. A decrease in APP in the first 48 hours of the desease in patients with ASP was, on average, accompanied by a reduction in the start of PI. In the study sample, it was possible to predict the time of PI initiation by measuring the APP level in the first 48 hours of the disease with a margin of error for 1.3 days. It was found that with a decrease in the APP level, the time of the PI occurrence was reduced (p<0.001), on average, by 0.47±0.02 days for each mm Hg of APP.