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

Evelina Sturini*, Andrea Saporito, Michael Sugrue, Michael J. A. Parr, Gillian Bishop, Antonio Braschi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)

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° 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.

Original languageEnglish
Pages (from-to)1632-1637
Number of pages6
JournalIntensive Care Medicine
Volume34
Issue number9
DOIs
Publication statusPublished - 1 Sep 2008
Externally publishedYes

Keywords

  • Abdominal compliance
  • Intensive care unit
  • Intra-abdominal hypertension
  • Intra-abdominal pressure
  • Mechanical ventilation
  • Respiratory variation

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