Interaction between intra-abdominal pressure and positive-end expiratory pressure
OBJECTIVE: The aim of this study was to quantify the interaction between increased intra-abdominal pressure and Positive-End Expiratory Pressure. METHODS: In 30 mechanically ventilated ICU patients with a fixed tidal volume, respiratory system plateau and abdominal pressure were measured at a Positi...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier España
2009-02-01
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| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322009000200007 |
| _version_ | 1828471254015803392 |
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| author | Jamili Anbar Torquato Jeanette Janaina Jaber Lucato Telma Antunes Carmen Valente Barbas |
| author_facet | Jamili Anbar Torquato Jeanette Janaina Jaber Lucato Telma Antunes Carmen Valente Barbas |
| author_sort | Jamili Anbar Torquato |
| collection | DOAJ |
| description | OBJECTIVE: The aim of this study was to quantify the interaction between increased intra-abdominal pressure and Positive-End Expiratory Pressure. METHODS: In 30 mechanically ventilated ICU patients with a fixed tidal volume, respiratory system plateau and abdominal pressure were measured at a Positive-End Expiratory Pressure level of zero and 10 cm H2O. The measurements were repeated after placing a 5 kg weight on the patients' belly. RESULTS: After the addition of 5 kg to the patients' belly at zero Positive-End Expiratory Pressure, both intra-abdominal pressure (p<0.001) and plateau pressures (p=0.005) increased significantly. Increasing the Positive-End Expiratory Pressure levels from zero to 10 cm H2O without weight on the belly did not result in any increase in intra-abdominal pressure (p=0.165). However, plateau pressures increased significantly (p< 0.001). Increasing Positive-End Expiratory Pressure from zero to 10 cm H2O and adding 5 kg to the belly increased intra-abdominal pressure from 8.7 to 16.8 (p<0.001) and plateau pressure from 18.26 to 27.2 (p<0.001). Maintaining Positive-End Expiratory Pressure at 10 cm H2O and placing 5 kg on the belly increased intra-abdominal pressure from 12.3 +/- 1.7 to 16.8 +/- 1.7 (p<0.001) but did not increase plateau pressure (26.6+/-1.2 to 27.2 +/-1.1 -p=0.83). CONCLUSIONS: The addition of a 5kg weight onto the abdomen significantly increased both IAP and the airway plateau pressure, confirming that intra-abdominal hypertension elevates the plateau pressure. However, plateau pressure alone cannot be considered a good indicator for the detection of elevated intra-abdominal pressure in patients under mechanical ventilation using PEEP. In these patients, the intra-abdominal pressure must also be measured. |
| first_indexed | 2024-12-11T05:07:48Z |
| format | Article |
| id | doaj.art-09fabfe6536e4fbbaa302f4771f281ad |
| institution | Directory Open Access Journal |
| issn | 1807-5932 1980-5322 |
| language | English |
| last_indexed | 2024-12-11T05:07:48Z |
| publishDate | 2009-02-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-09fabfe6536e4fbbaa302f4771f281ad2022-12-22T01:19:59ZengElsevier EspañaClinics1807-59321980-53222009-02-0164210511210.1590/S1807-59322009000200007Interaction between intra-abdominal pressure and positive-end expiratory pressureJamili Anbar TorquatoJeanette Janaina Jaber LucatoTelma AntunesCarmen Valente BarbasOBJECTIVE: The aim of this study was to quantify the interaction between increased intra-abdominal pressure and Positive-End Expiratory Pressure. METHODS: In 30 mechanically ventilated ICU patients with a fixed tidal volume, respiratory system plateau and abdominal pressure were measured at a Positive-End Expiratory Pressure level of zero and 10 cm H2O. The measurements were repeated after placing a 5 kg weight on the patients' belly. RESULTS: After the addition of 5 kg to the patients' belly at zero Positive-End Expiratory Pressure, both intra-abdominal pressure (p<0.001) and plateau pressures (p=0.005) increased significantly. Increasing the Positive-End Expiratory Pressure levels from zero to 10 cm H2O without weight on the belly did not result in any increase in intra-abdominal pressure (p=0.165). However, plateau pressures increased significantly (p< 0.001). Increasing Positive-End Expiratory Pressure from zero to 10 cm H2O and adding 5 kg to the belly increased intra-abdominal pressure from 8.7 to 16.8 (p<0.001) and plateau pressure from 18.26 to 27.2 (p<0.001). Maintaining Positive-End Expiratory Pressure at 10 cm H2O and placing 5 kg on the belly increased intra-abdominal pressure from 12.3 +/- 1.7 to 16.8 +/- 1.7 (p<0.001) but did not increase plateau pressure (26.6+/-1.2 to 27.2 +/-1.1 -p=0.83). CONCLUSIONS: The addition of a 5kg weight onto the abdomen significantly increased both IAP and the airway plateau pressure, confirming that intra-abdominal hypertension elevates the plateau pressure. However, plateau pressure alone cannot be considered a good indicator for the detection of elevated intra-abdominal pressure in patients under mechanical ventilation using PEEP. In these patients, the intra-abdominal pressure must also be measured.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322009000200007Respiratory MechanicsEnd-Positive Airway PressurePlateau pressuresIntra-abdominal pressurePositive Pressure Mechanical Ventilation |
| spellingShingle | Jamili Anbar Torquato Jeanette Janaina Jaber Lucato Telma Antunes Carmen Valente Barbas Interaction between intra-abdominal pressure and positive-end expiratory pressure Clinics Respiratory Mechanics End-Positive Airway Pressure Plateau pressures Intra-abdominal pressure Positive Pressure Mechanical Ventilation |
| title | Interaction between intra-abdominal pressure and positive-end expiratory pressure |
| title_full | Interaction between intra-abdominal pressure and positive-end expiratory pressure |
| title_fullStr | Interaction between intra-abdominal pressure and positive-end expiratory pressure |
| title_full_unstemmed | Interaction between intra-abdominal pressure and positive-end expiratory pressure |
| title_short | Interaction between intra-abdominal pressure and positive-end expiratory pressure |
| title_sort | interaction between intra abdominal pressure and positive end expiratory pressure |
| topic | Respiratory Mechanics End-Positive Airway Pressure Plateau pressures Intra-abdominal pressure Positive Pressure Mechanical Ventilation |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322009000200007 |
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