TY - JOUR
T1 - Respiratory variation of intra-abdominal pressure
T2 - indirect indicator of abdominal compliance?
AU - Sturini, Evelina
AU - Saporito, Andrea
AU - Sugrue, Michael
AU - Parr, Michael J. A.
AU - Bishop, Gillian
AU - Braschi, Antonio
PY - 2008/9/1
Y1 - 2008/9/1
N2 - 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° 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° 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.
AB - 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° 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° 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.
KW - Abdominal compliance
KW - Intensive care unit
KW - Intra-abdominal hypertension
KW - Intra-abdominal pressure
KW - Mechanical ventilation
KW - Respiratory variation
UR - http://www.scopus.com/inward/record.url?scp=49749119992&partnerID=8YFLogxK
U2 - 10.1007/s00134-008-1155-z
DO - 10.1007/s00134-008-1155-z
M3 - Article
C2 - 18500420
AN - SCOPUS:49749119992
SN - 0342-4642
VL - 34
SP - 1632
EP - 1637
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 9
ER -