Intra-abdominal pressure and mechanical artificial ventilation. Arnaldo Milián Castro Hospital. 2014-2015
Abstract
Introduction: The abdominal cavity and the thoracic cage are separated by the diaphragm; therefore, the variations in the pressures within one of them have an effect on the pressures of the other. At present, intra-abdominal hypertension is a frequent entity in the critically ill patient, which constitutes an important risk factor for complications and mortality since it influences on different organs and systems.
Objective: To relate intra-abdominal pressure with mechanical artificial ventilation pressures and parameters of respiratory, cardiovascular and renal function.
Material and Methods: A descriptive prospective study of intra-abdominal pressure was conducted in patients undergoing mechanical ventilation with clinical and surgical diseases in the Intensive Care Units of the Arnaldo Milán Castro Hospital, during the period between January 2014 until December 2015.
Results: Clinical patients with high values of airway pressures showed higher values of intra-abdominal pressure, and those post-surgical patients who presented with high levels of pressure inside the abdomen indicated the highest values of peak and average pressure recorded in the mechanical ventilator.
Conclusions: Mean arterial pressure, diuretic rate and peripheral oxygen saturation decreased, whereas the central venous pressure, the partial pressure of carbon dioxide in blood, and creatinine increased due to raises in pressure within the abdomen.
Keywords: Artificial respiration, transcutaneous blood gas monitoring, arterial pressure, diuresis, abdomen.
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References
1. Soler Morejón C. Estudio de la Presión Intraabdominal en pacientescríticos sin afección abdominal. [tesis]. La Habana: Universidad de Ciencias Médicas de La Habana; 2005.
2. Maluso P, Olson J, Sarani B. Abdominal Compartment Hypertension and Abdominal Compartment Syndrome. Washington: Elsevier; 2016.
3. Gattinoni L, Pelosi P, Suter PM, Pedoto A, Vercesi P, Lissoni A. Acute Respiratory Distress Syndrome Caused by Pulmonary and Extrapulmonary Disease Different yndromes?. Am J RespCrit Care Med. 1998;158:3-11.
4. Fernández-Llamazares J. Síndrome compartimental abdominal en el paciente crítico con abdomen agudo y pancreatitis aguda grave. [Tesis]. Barcelona: Universidad Autónoma; 2009.
5. Medrano Montero E, Ramírez Pu R, Medina Meriño C, Miranda Lorenzo D. Medición de la presión intraabdominal para la vigilancia posoperatoria de la cirugía abdominal. Rev Cubana Cir. 2007;46:0.
6. Wu Y-F, Zheng Y-P, Zhang N, Liu H, Zheng Q-X, Yang F-T, et al. Study on the correlation between the changes in intra-abdominal pressure and renal functional in the patients with abdominal compartment syndrome. Eur Rev Med Pharmacol Sci. 2015;19(19):3682-7.
7. Yang C, Yang Z, Chen X, Liu T, Gou S, Chen C, et al. Inverted U-Shaped Relationship between Central Venous Pressure and Intra-Abdominal Pressure in the Early Phase of Severe Acute Pancreatitis: A Retrospective Study. PLoS One. 2015;10(6):e0128493.
8. González L, Rodríguez R, Mencia S, Gil-Ruiz M, Sanavia E. López Herce J. Utilidad de la monitorización de la presión intraabdominal en el niño crítico. AnPed. 2012;77(4):254-60.
9. Davarci I, Karcioglu M, Tuzcu K, Inanoglu K, Yetim TD, Motor S, et al. Evidence for negative effects of elevated intra-abdominal pressure on pulmonary mechanics and oxidative stress. Scientific World J. 2015;2015:612642.
10. Liu F, Zhu S, Ji Q, Li W, Liu J. The impact of intra-abdominal pressure on the stroke volume variation and plethysmographic variability index in patients undergoing laparoscopic cholecystectomy. Biosci Trends. 2015;9(2):129-33.
11. Gavrilovska-Brzanov A, Nikolova Z, Jankulovski N, Sosolceva M, Taleska G, Mojsova-Mijovska M, et al. Evaluation of the Effects of Elevated Intra-abdominal Pressure on the Respiratory Mechanics in Mechanically Ventilated Patients. Macedonian J MedScienc. 2013; 6(3):261-65.
12. Aguilar Sabillón G. CaracterizacionClinica de la hipertensión y síndrome compartamental abdominal. [tesis]. Guatemala: Universidad de San Carlos Facultad de Ciencias Médicas; 2014.
13. Zhang H-Y, Liu D, Tang H, Sun S-J, Ai S-M, Yang W-Q, et al. The effect of different types of abdominal binders on intra-abdominal pressure. SaudiMed J. 2016;37(1):66-72.
14. Angelici AM, Perotti B, Dezzi C, Amatucci C, Mancuso G, Caronna R, et al. Measurement of intra-abdominal pressure in large incisional hernia repair to prevent abdominal compartmental syndrome. G Chir. 2016;37(1):31-6.
15. Kuteesa J, Kituuka O, Namuguzi D, Ndikuno C, Kirunda S, Mukunya D, et al. Intra-abdominal hypertension; prevalence, incidence and outcomes in a low resource setting; a prospective observational study. World J Emerg Surg. 2015;10(57):51-4.
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