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Abdominal Distension

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Michael P. Hlastala – One of the best experts on this subject based on the ideXlab platform.

  • Pulmonary gas exchange improves in the prone position with Abdominal Distension.
    American journal of respiratory and critical care medicine, 1998
    Co-Authors: M. Mure, Robb W. Glenny, Karen B. Domino, Michael P. Hlastala

    Abstract:

    Arterial blood oxygenation in patients with adult respiratory distress syndrome is often improved in the prone position. Critically ill patients often have Abdominal Distension and whether similar improvements in gas exchange occur with the prone position is not known. We therefore studied the effect of posture on gas exchange in eight ketamine-anesthetized pigs with Abdominal Distension. A rubber balloon, placed in the Abdominal cavity, was filled with water to increase intra-Abdominal pressure. The animals were mechanically ventilated with FIO2 = 0.4, and PaCO2 was kept constant. Gas exchange was measured in the supine and prone positions, with and without Abdominal Distension, in random order, using the multiple inert gas elimination technique (MIGET). When the abdomen was normal, the prone position increased PaO2 by 16 +/- 21 mm Hg (p < 0.05), accompanied by a small, but statistically insignificant, decrease in AaPO2 (p = 0.08) and no change in ventilation/perfusion (V A/Q) heterogeneity measured by MIGET. In the presence of Abdominal Distension, the prone position increased Pa O2 by 26 +/- 18 mm Hg (p < 0.01) and decreased AaPO2 (p < 0.05) and V A/Q heterogeneity as measured by the log standard deviation of the perfusion distribution (p < 0.01) and the arterial-alveolar difference area (p < 0.05). In addition, intragastric pressure was lower in the prone position (p < 0.01). We conclude that in anesthetized, mechanically ventilated pigs, the prone position improves pulmonary gas exchange to a greater degree in the presence of Abdominal Distension than when the abdomen is normal.

  • pulmonary gas exchange improves in the prone position with Abdominal Distension
    American Journal of Respiratory and Critical Care Medicine, 1998
    Co-Authors: M. Mure, Robb W. Glenny, Karen B. Domino, Michael P. Hlastala

    Abstract:

    Arterial blood oxygenation in patients with adult respiratory distress syndrome is often improved in the prone position. Critically ill patients often have Abdominal Distension and whether similar improvements in gas exchange occur with the prone position is not known. We therefore studied the effect of posture on gas exchange in eight ketamine-anesthetized pigs with Abdominal Distension. A rubber balloon, placed in the Abdominal cavity, was filled with water to increase intra-Abdominal pressure. The animals were mechanically ventilated with Fi O2 = 0.4, and PaCO2 was kept constant. Gas exchange was measured in the supine and prone positions, with and without Abdominal Distension, in random order, using the multiple inert gas elimination technique (MIGET). When the abdomen was normal, the prone position increased PaO2 by 16 ± 21 mm Hg (p < 0.05), accompanied by a small, but statistically insignificant, decrease in aaPo 2 (p = 0.08) and no change in ventilation/perfusion (V˙ a/Q˙) heterogeneity measured by...

  • Pulmonary gas exchange in pigs improves in the prone position with Abdominal Distension
    Critical Care, 1998
    Co-Authors: M. Mure, Robb W. Glenny, Karen B. Domino, Michael P. Hlastala

    Abstract:

    Partial pressure of oxygen (PaO2) in arterial blood tend to be higher in the prone compared to supine position. Whether similar improvements in gas exchange occur in the presence of Abdominal Distension is not clear. We studied the effect of position on gas exchange in eight ketamine anesthetized, mechanically ventilated pigs with Abdominal Distension. A intraAbdominal rubber balloon, was used to increase intraAbdominal pressure. Gas exchange was measured in the supine and prone positions, with and without Abdominal Distension, in random order using the multiple inert gas elimination technique. In presence of normal abdomen, only PaO2 increased (P < 0.05). In contrast, in the prone position with Abdominal Distension, the PaO2 (P < 0.01) increased and AaPO2 (P < 0.05) and AA/ heterogeneity, indicated by log SD (P < 0.01) and [(a-A)D] area (P < 0.05) were decreased in the prone compared to the supine position. We conclude that the prone position increases PaO2 by improving gas exchange in pigs with Abdominal Distension.

T Fiore – One of the best experts on this subject based on the ideXlab platform.

  • impairment of lung and chest wall mechanics in patients with acute respiratory distress syndrome role of Abdominal Distension
    American Journal of Respiratory and Critical Care Medicine, 1997
    Co-Authors: Marco V Ranieri, N Brienza, Sergio Santostasi, Filomena Puntillo, Luciana Mascia, Nicola Vitale, R Giuliani, Vincenzo Memeo, F Bruno, T Fiore

    Abstract:

    Recent data have suggested that the elastic properties of the chest wall (CW) may be compromised in patients with ARDS because of Abdominal Distension (4). We partitioned CW and lung (L) mechanics, assessed the role of Abdominal Distension, and verified whether the underlying disease responsible for ARDS affects the impairment of respiratory mechanics. Volume-pressure (V-P) curves (interrupter technique) were assessed in nine patients with surgical ARDS and nine patients with medical ARDS. Relative to nine patients undergoing heart surgery, V-P curves of the respiratory system (rs) and L of patients with surgical or medical ARDS showed a rightward displacement. V-P curves of the CW and the L showed an upward concavity in patients with medical ARDS and a downward concavity in patients with surgical ARDS. Although the CW and the abdomen (abd) V-P curves in patients with medical ARDS were similar to those obtained in patients undergoing heart surgery, they showed a rightward shift and a downward flattening i…

  • Impairment of lung and chest wall mechanics in patients with acute respiratory distress syndrome: role of Abdominal Distension.
    American journal of respiratory and critical care medicine, 1997
    Co-Authors: V M Ranieri, N Brienza, Sergio Santostasi, Filomena Puntillo, Luciana Mascia, Nicola Vitale, R Giuliani, Vincenzo Memeo, F Bruno, T Fiore

    Abstract:

    Recent data have suggested that the elastic properties of the chest wall (CW) may be compromised in patients with ARDS because of Abdominal Distension (4). We partitioned CW and lung (L) mechanics, assessed the role of Abdominal Distension, and verified whether the underlying disease responsible for ARDS affects the impairment of respiratory mechanics. Volume-pressure (V-P) curves (interrupter technique) were assessed in nine patients with surgical ARDS and nine patients with medical ARDS. Relative to nine patients undergoing heart surgery, V-P curves of the respiratory system (rs) and L of patients with surgical or medical ARDS showed a rightward displacement. V-P curves of the CW and the L showed an upward concavity in patients with medical ARDS and a downward concavity in patients with surgical ARDS. Although the CW and the abdomen (abd) V-P curves in patients with medical ARDS were similar to those obtained in patients undergoing heart surgery, they showed a rightward shift and a downward flattening in patients with surgical ARDS. In five of these patients, a reduction in static end-inspiratory pressure of the abd (69+/-4%), rs (30+/-3%), CW (41+/-2%), and L (27+/-3%) was observed after Abdominal decompression for acute bleeding. Abdominal decompression therefore caused an upward and leftward shift of the V-P curves of the respiratory system, chest wall, lung, and abdomen. In conclusion we showed that impairment of the elastic properties of the respiratory system may vary with the underlying disease responsible for ARDS. The flattening of the V-P curve at high pressures observed in some patients with ARDS may be due to an increase in chest wall elastance related to Abdominal Distension. These observations have implications for the assessment and ventilatory management of patients with ARDS.

Abelardo Margolles – One of the best experts on this subject based on the ideXlab platform.

  • Abdominal Distension after eating lettuce the role of intestinal gas evaluated in vitro and by Abdominal ct imaging
    Neurogastroenterology and Motility, 2019
    Co-Authors: Elizabeth Barba, Emanuel Burri, Anna Accarino, Eva Monclus, Isabel Navazo, Abelardo Margolles, Borja Sanchez, Francisco Guarner

    Abstract:

    Background: Some patients complain that eating lettuce, gives them gas and Abdominal distention. Our aim was to determine to what extent the patients’ assertion is sustained by evidence.
    Methods: An in vitro study measured the amount of gas produced during the process of fermentation by a preparation of human colonic microbiota (n = 3) of predigested lettuce, as compared to beans, a high gas-releasing substrate, to meat, a low gas-releasing substrate, and to a nutrient-free negative control. A clinical study in patients complaining of Abdominal distention after eating lettuce (n = 12) measured the amount of intestinal gas and the morphometric configuration of the Abdominal cavity in Abdominal CT scans during an episode of lettuce-induced Distension as compared to basal conditions.
    Key Results: Gas production by microbiota fermentation of lettuce in vitro was similar to that of meat (P = .44), lower than that of beans (by 78 ± 15%; P < .001) and higher than with the nutrient-free control (by 25 ± 19%; P = .05). Patients complaining of Abdominal Distension after eating lettuce exhibited an increase in girth (35 ± 3 mm larger than basal; P < .001) without significant increase in colonic gas content (39 ± 4 mL increase; P = .071); Abdominal Distension was related to a descent of the diaphragm (by 7 ± 3 mm; P = .027) with redistribution of normal Abdominal contents.
    Conclusion and Inferences: Lettuce is a low gas-releasing substrate for microbiota fermentation and lettuce-induced Abdominal Distension is produced by an uncoordinated activity of the Abdominal walls. Correction of the somatic response might be more effective than the current dietary restriction strategy.