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Respiratory variation of intra-abdominal pressure: indirect indicator of abdominal compliance?

Abstract：

OBJECTIVE:To assess if the observed respiratory cycle-related variation in intra-abdominal pressure is reliably quantifiable and a possible indirect indicator of abdominal compliance. Secondary issues were to assess the roles played by respiratory parameters in determining this oscillation and by patients' position in increasing their intra-abdominal pressure. DESIGN AND SETTING:Prospective observational study in a 26-bed medical-surgical intensive care unit. PATIENTS:Sixteen consecutive patients admitted to intensive care for at least 24 h, requiring mechanical ventilation and intra-abdominal pressure monitoring. MEASUREMENTS AND RESULTS:Intra-abdominal pressure was measured with a modified Kron technique; its waveform was recorded and inspiratory and expiratory values were measured during five consecutive respiratory cycles for 5 days, both in the supine and the 30 degrees head-up position. Inspiratory values were significantly higher than expiratory values (p = 0.001) and a correlation was found between their difference and intra-abdominal pressure basal values (p = 0.025). A positive linear relationship was shown between intra-abdominal pressure and the amplitude of its oscillation (r = 0.4), particularly in the subgroup of patients with intra-abdominal hypertension (r = 0.9). Intra-abdominal pressure was lower in patients supine than in the 30 degrees head-up position (p = 0.001). CONCLUSIONS:Respiratory cycle-related variations in intra-abdominal pressure were specifically investigated, quantified and shown as linearly increasing with end-expiratory intra-abdominal pressure; this phenomenon could be explained by patients' abdominal compliance status. Supine posture should be an important consideration in specific patients affected by intra-abdominal hypertension.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Sturini E,Saporito A,Sugrue M,Parr MJ,Bishop G,Braschi A

doi

10.1007/s00134-008-1155-z

subject

Has Abstract

pub_date

2008-09-01 00:00:00

pages

1632-7

issue

9

eissn

0342-4642

issn

1432-1238

journal_volume

34

pub_type

杂志文章

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