Document Detail


[Intraabdominal and thoracic pressure in critically ill patients with suspected intraabdominal hypertension].
MedLine Citation:
PMID:  21497415     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study the correlation between intraabdominal and intrathoracic pressure in patients with suspected intraabdominal hypertension.
DESIGN: A prospective, observational cohort study.
SETTING: Polyvalent intensive care unit of a University hospital.
PATIENTS: Twenty-seven medical-surgical patient dependent upon controlled mechanical ventilation due to acute respiratory failure and with several risk factors for intraabdominal hypertension (IAH).
MAIN VARIABLES: Intraabdominal (IAP), esophageal (Peso) and airways pressure were measured under static (st) and dynamic (dyn) conditions. Respiratory system (Crs), lung (Cl) and chest wall compliance (Ccw)were calculated.
RESULTS: In 10 patients IAP > 12 mmHg (IAH, IAPst, 14 ± 2 [12-21] mmHg), while in the rest the pressure proved normal (n = 17; IAPst, 8 ± 2 [3-11] mmHg). Peso st was 11 ± 5 (2-27) and Peso dyn 7 ± 4 (2-24) cmH₂O. Depending on the presence or absence of IAH, Peso st was 9 ± 4 vs 7 ± 3 cmH₂O (p = 0.2) and Peso dyn 6 ± 2 vs 4 ± 3 cmH₂O (p = 0.3), respectively. The correlation between Peso st and dyn with IAPst was 0.5 (p= 0.003) and 0.4 (p = 0.03), respectively. The compliance components were decreased (Crs, 31 ± 8; Cl, 52 ± 22 and Ccw, 105 ± 50 ml/cmH₂O); Ccw was significantly lower in patients with IAH (81 ± 31 vs 118 ± 55 ml/cmH₂O; p = 0.02). The correlation coefficient between IAPst and Ccw was -0.7 (p < 0.001), and -0.5 (p = 0.002) with respect to Crs.
CONCLUSIONS: A stiffer chest wall was observed in patients with IAH. In patients with risk factors for IAH, pressures in these compartments were highly variable.
Authors:
F Ruiz Ferrón; A Tejero Pedregosa; M Ruiz García; A Ferrezuelo Mata; J Pérez Valenzuela; R Quirós Barrera; L Rucabado Aguilar
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Publication Detail:
Type:  English Abstract; Journal Article     Date:  2011-04-15
Journal Detail:
Title:  Medicina intensiva / Sociedad Española de Medicina Intensiva y Unidades Coronarias     Volume:  35     ISSN:  1578-6749     ISO Abbreviation:  Med Intensiva     Publication Date:    2011 Jun-Jul
Date Detail:
Created Date:  2011-05-23     Completed Date:  2011-11-03     Revised Date:  2012-01-18    
Medline Journal Info:
Nlm Unique ID:  9207689     Medline TA:  Med Intensiva     Country:  Spain    
Other Details:
Languages:  spa     Pagination:  274-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2009 Elsevier España, S.L. y SEMICYUC. All rights reserved.
Affiliation:
Servicio de Cuidados Críticos y Urgencias, Unidad de Medicina Intensiva, Hospital Médico-Quirúrgico, Complejo Hospitalario de Jaén, Jaén, España. frferron@terra.es
Vernacular Title:
Presión intraabdominal y torácica en pacientes críticos con sospecha de hipertensión intraabdominal.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Cavity*
Aged
Critical Illness
Female
Humans
Hypertension / physiopathology*
Male
Pressure
Prospective Studies
Thorax*

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