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Antonio Braschi - One of the best experts on this subject based on the ideXlab platform.
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Respiratory variation of intra-Abdominal Pressure: indirect indicator of Abdominal compliance?
Intensive Care Medicine, 2008Co-Authors: Evelina Sturini, Andrea Saporito, Michael Sugrue, Michael J. A. Parr, Gillian Bishop, Antonio BraschiAbstract: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.
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Respiratory variation of intra-Abdominal Pressure: indirect indicator of Abdominal compliance?
Intensive care medicine, 2008Co-Authors: Evelina Sturini, Andrea Saporito, Michael Sugrue, Gillian Bishop, Michael Parr, Antonio BraschiAbstract: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.
Michael Sugrue - One of the best experts on this subject based on the ideXlab platform.
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Respiratory variation of intra-Abdominal Pressure: indirect indicator of Abdominal compliance?
Intensive Care Medicine, 2008Co-Authors: Evelina Sturini, Andrea Saporito, Michael Sugrue, Michael J. A. Parr, Gillian Bishop, Antonio BraschiAbstract: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.
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Respiratory variation of intra-Abdominal Pressure: indirect indicator of Abdominal compliance?
Intensive care medicine, 2008Co-Authors: Evelina Sturini, Andrea Saporito, Michael Sugrue, Gillian Bishop, Michael Parr, Antonio BraschiAbstract: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.
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Intra-Abdominal Pressure
Clinical Intensive Care, 1995Co-Authors: Michael SugrueAbstract:The Abdominal cavity is the space limited by the diaphragm above and the musculo-aponeurotic perineum below, the lumbosacral spine posteriorly and the walls of the Abdominal cavity anterolaterally. Intra-Abdominal Pressure (IAP) is a steady-state Pressure within the Abdominal cavity and while transient rapid increases occur during muscular activity and straining,1 the normal range is 0-5 mmHg. What constitutes increased intraAbdominal Pressure is arbitrary, and while some authors define an increase as a Pressure ≥10 mmHg,2 others suggest ≥14 mmHg,3 ≥18 mmHg4 or ≥20 mmHg,5,6 It would be reasonable to assume that an IAP ≥15 mmHg is elevated.
Hae Ja Lim - One of the best experts on this subject based on the ideXlab platform.
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Effect of Positive End Expiratory Pressure on Intra-Abdominal Pressure and Abdominal Perfusion Pressure at an Increased Intra-Abdominal Pressure
Korean Journal of Anesthesiology, 2007Co-Authors: Choon Hak Lim, Younsuck Koh, Hye Won Lee, Ji Young Khil, Sung Ok Suh, Young Chol Kim, Hae Ja LimAbstract:S 31 Received:August 1, 2007 Corresponding to:Hye Won Lee, Department of Anesthesiology and Pain Medicine, Korea University Medical Center, 126-1, Anam-dong 5-ga, Seongbuk-gu, Seoul 136-705, Korea. Tel: 82-2-920-5478, Fax: 822-928-2275, E-mail: hyewonmd@unitel.co.kr. This study was supported by the grant from the Korea Health 21 R&D Project of the Ministry of Health & Welfare (grant no. 02-PJ3-PG6EV09-0001) and the Brain Korea 21 Project of the Ministry of Education and Human Resources Development, Republic of Korea. The 6 Joint Scientific Congress of the JSICM and KSCCM, 2006, Osaka. Effect of Positive End Expiratory Pressure on Intra-Abdominal Pressure and Abdominal Perfusion Pressure at an Increased Intra-Abdominal Pressure
Evelina Sturini - One of the best experts on this subject based on the ideXlab platform.
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Respiratory variation of intra-Abdominal Pressure: indirect indicator of Abdominal compliance?
Intensive Care Medicine, 2008Co-Authors: Evelina Sturini, Andrea Saporito, Michael Sugrue, Michael J. A. Parr, Gillian Bishop, Antonio BraschiAbstract: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.
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Respiratory variation of intra-Abdominal Pressure: indirect indicator of Abdominal compliance?
Intensive care medicine, 2008Co-Authors: Evelina Sturini, Andrea Saporito, Michael Sugrue, Gillian Bishop, Michael Parr, Antonio BraschiAbstract: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.
Franco Mosca - One of the best experts on this subject based on the ideXlab platform.
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Intra-Abdominal Pressure monitoring in liver transplant recipients: a prospective study
Intensive care medicine, 2002Co-Authors: Gianni Biancofiore, Maria L. Bindi, Anna Maria Romanelli, A Boldrini, G Consani, M Bisà, Franco Filipponi, A. Vagelli, Franco MoscaAbstract:Abstract Objective. No data are available on the incidence and clinical relevance of increased intra-Abdominal Pressure after orthotopic liver transplantation. This study assessed Abdominal hypertension in a population of transplanted patients as this may be an important cofactor in early postoperative complications. Design and setting. Prospective clinical study in an intensive care unit of a national health system teaching hospital Patients and measurements. Abdominal Pressure was measured every 6 h using the urinary bladder method and was considered elevated when it was 25 mmHg or higher. Hemodynamic status was evaluated at the same times. Renal function was assessed on the basis of hourly urinary output by calculating serum creatinine on postoperative days 2 and 4 and the filtration gradient; patient outcomes were also considered. Results. Intra-Abdominal hypertension was observed in 32% of cases; the subjects with high Abdominal Pressure had significantly lower mean artery Pressure values but did not differ in terms of central venous Pressure or cardiac output. High intra-Abdominal Pressure was more frequently associated with renal failure, a lower filtration gradient, delayed postsurgical weaning from ventilation, and a worse outcome. Conclusions. Abdominal hypertension is frequent after liver transplantation and may be associated with a complicated post-operative course.
