Positive end-expiratory pressure affects the value of intra-abdominal pressure in acute lung injury/ acute respiratory distress syndrome patients: a pilot study - Université de Montpellier Accéder directement au contenu
Article Dans Une Revue Critical Care Année : 2010

Positive end-expiratory pressure affects the value of intra-abdominal pressure in acute lung injury/ acute respiratory distress syndrome patients: a pilot study

Résumé

Introduction: To examine the effects of positive end-expiratory pressure (PEEP) on intra-abdominal pressure (IAP) in patients with acute lung injury (ALI).Methods: Thirty sedated and mechanically ventilated patients with ALI or acute respiratory distress syndrome (ARDS) admitted to a sixteen-bed surgical medical ICU were included. All patients were studied with sequentially increasing PEEP (0, 6 and 12 cmH2O) during a PEEP-trial.Results: Age was 55 ± 17 years, weight was 70 ± 17 kg, SAPS II was 44 ± 14 and PaO2/FIO2 was 192 ± 53 mmHg. The IAP was 12 ± 5 mmHg at PEEP 0 (zero end-expiratory pressure, ZEEP), 13 ± 5 mmHg at PEEP 6 and 15 ± 6 mmHg at PEEP 12 (P < 0.05 vs ZEEP). In the patients with intra-abdominal hypertension defined as IAP ≥ 12 mmHg (n = 15), IAP significantly increased from 15 ± 3 mmHg at ZEEP to 20 ± 3 mmHg at PEEP 12 (P < 0.01). Whereas in the patients with IAP < 12 mmHg (n = 15), IAP did not significantly change from ZEEP to PEEP 12(8 ± 2 vs 10 ± 3 mmHg). In the 13 patients in whom cardiac output was measured, increase in PEEP from 0 to 12 cmH2O did not significantly change cardiac output, nor in the 8 out of 15 patients of the high-IAP group. The observed effects were similar in both ALI (n = 17) and ARDS (n = 13) patients.Conclusions: PEEP is a contributing factor that impacts IAP values. It seems necessary to take into account the level of PEEP whilst interpreting IAP values in patients under mechanical ventilation.
Fichier principal
Vignette du fichier
Verzilli et al - 2010.pdf (296.66 Ko) Télécharger le fichier
Origine Fichiers éditeurs autorisés sur une archive ouverte
Loading...

Dates et versions

hal-02549757 , version 1 (21-04-2020)

Identifiants

Citer

Daniel Verzilli, Jean-Michel Constantin, Mustapha Sebbane, Gerald Chanques, Boris Jung, et al.. Positive end-expiratory pressure affects the value of intra-abdominal pressure in acute lung injury/ acute respiratory distress syndrome patients: a pilot study. Critical Care, 2010, ⟨10.1186/cc9193⟩. ⟨hal-02549757⟩
20 Consultations
49 Téléchargements

Altmetric

Partager

Gmail Mastodon Facebook X LinkedIn More