EFFECT OF INTRA-ABDOMINAL PRESSURE ON RESPIRATORY MECHANICS

2007 ◽  
Vol 62 (sup1) ◽  
pp. 78-88 ◽  
Author(s):  
P. Pelosi ◽  
M. Quintel ◽  
M.L.N.G. Malbrain
Keyword(s):  
Respiratory Mechanics ◽  
Abdominal Pressure

scholarly journals Unusually High Intra-abdominal Opening Pressure Confirmed by Simultaneous Gastric Pressure Measurement during Laparoscopy

2012 ◽  
Vol 6 (1) ◽  
pp. 12-15
Author(s):  
Richard Matulewicz ◽  
Antonio R. Gargiulo ◽  
Stephen H. Loring ◽  
Massimo Ferrigno
Keyword(s):  
Respiratory Mechanics ◽  
Obese Woman ◽  
Veress Needle ◽  
Abdominal Pressure ◽  
Needle Placement ◽  
Opening Pressure ◽  
Robot Assisted ◽  
Gastric Pressure ◽  
High Degree ◽  
Viable Method

A 28 year-old obese woman was scheduled for robot-assisted bilateral tubal re-anastomosis under general anesthesia and neuromuscular blockade. As part of a respiratory mechanics study, gastric pressure (Pga) was measured. At the beginning of the operation, the surgeon repeatedly inserted a Veress needle consistently measuring an unusually high opening pressure of 15 mmHg, at a time when Pga was 12.5 mmHg. Based on the elevated Pga values, we inferred that the high opening pressure was a valid intra-peritoneal pressure, rather than a sign of incorrect needle placement; therefore, the surgeon proceeded with uneventful insufflation of the peritoneal cavity. This patient exhibited an unusually high opening intra-abdominal pressure that likely reflected her high degree of central obesity. Simultaneous Pga determination proved valuable in confirming intra-peritoneal location of the tip of Veress needle and may be a viable method of corroborating high opening pressures despite safe needle positions in laparoscopic cases.

A Three-Dimensional Human Trunk Model for the Analysis of Respiratory Mechanics

2009 ◽  
Vol 132 (1) ◽  
Author(s):  
Michel Behr ◽  
Jeremie Pérès ◽  
Maxime Llari ◽  
Yves Godio ◽  
Yves Jammes ◽  
...  
Keyword(s):  
Road Safety ◽  
Mechanical Response ◽  
Respiratory Mechanics ◽  
Numerical Models ◽  
Three Dimensional ◽  
Abdominal Pressure ◽  
Fe Model ◽  
Safety Research ◽  
Impact Biomechanics ◽  
Validation Parameters

Over the past decade, road safety research and impact biomechanics have strongly stimulated the development of anatomical human numerical models using the finite element (FE) approach. The good accuracy of these models, in terms of geometric definition and mechanical response, should now find new areas of application. We focus here on the use of such a model to investigate its potential when studying respiratory mechanics. The human body FE model used in this study was derived from the RADIOSS® HUMOS model. Modifications first concerned the integration and interfacing of a user-controlled respiratory muscular system including intercostal muscles, scalene muscles, the sternocleidomastoid muscle, and the diaphragm and abdominal wall muscles. Volumetric and pressure measurement procedures for the lungs and both the thoracic and abdominal chambers were also implemented. Validation of the respiratory module was assessed by comparing a simulated maximum inspiration maneuver to volunteer studies in the literature. Validation parameters included lung volume changes, rib rotations, diaphragm shape and vertical deflexion, and intra-abdominal pressure variation. The HUMOS model, initially dedicated to road safety research, could be turned into a promising, realistic 3D model of respiration with only minor modifications.

scholarly journals Computed tomographic assessment of lung aeration at different positive end-expiratory pressures in a porcine model of intra-abdominal hypertension and lung injury

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Adrian Regli ◽  
Siavash Ahmadi-Noorbakhsh ◽  
Gabrielle Christine Musk ◽  
David Joseph Reese ◽  
Peter Herrmann ◽  
...  
Keyword(s):  
Lung Injury ◽  
Respiratory Mechanics ◽  
Peep Level ◽  
Large Animal Model ◽  
Arterial Oxygen ◽  
Abdominal Pressure ◽  
Large Animal ◽  
Computed Tomographic ◽  
Abdominal Hypertension ◽  
Alveolar Overdistension

Abstract Background Intra-abdominal hypertension (IAH) is common in critically ill patients and is associated with increased morbidity and mortality. High positive end-expiratory pressures (PEEP) can reverse lung volume and oxygenation decline caused by IAH, but its impact on alveolar overdistension is less clear. We aimed to find a PEEP range that would be high enough to reduce atelectasis, while low enough to minimize alveolar overdistention in the presence of IAH and lung injury. Methods Five anesthetized pigs received standardized anesthesia and mechanical ventilation. Peritoneal insufflation of air was used to generate intra-abdominal pressure of 27 cmH2O. Lung injury was created by intravenous oleic acid. PEEP levels of 5, 12, 17, 22, and 27 cmH2O were applied. We performed computed tomography and measured arterial oxygen levels, respiratory mechanics, and cardiac output 5 min after each new PEEP level. The proportion of overdistended, normally aerated, poorly aerated, and non-aerated atelectatic lung tissue was calculated based on Hounsfield units. Results PEEP decreased the proportion of poorly aerated and atelectatic lung, while increasing normally aerated lung. Overdistension increased with each incremental increase in applied PEEP. “Best PEEP” (respiratory mechanics or oxygenation) was higher than the “optimal CT inflation PEEP range” (difference between lower inflection points of atelectatic and overdistended lung) in healthy and injured lungs. Conclusions Our findings in a large animal model suggest that titrating a PEEP to respiratory mechanics or oxygenation in the presence of IAH is associated with increased alveolar overdistension.

Effects of intra-abdominal pressure on respiratory mechanics in healthy and injured lungs

2001 ◽  
Vol 18 (Supplement 21) ◽  
pp. 113
Author(s):  
P. Pelosi ◽  
J. P. Meinhardt ◽  
P. Caironi ◽  
M. Quintel ◽  
L. Gattinoni
Keyword(s):  
Respiratory Mechanics ◽  
Abdominal Pressure

Effect of positive expiratory pressure in respiratory mechanics, hemodynamics, and intra-abdominal pressure in high-risk patients for intra-abdominal hypertension and abdominal compartmental syndrome

2017 ◽  
Vol 42 ◽  
pp. 387-388
Author(s):  
Natalia Pedrosa Goulart de Andrade ◽  
Gabrielle Caroline Castanheira de Souza ◽  
Melissa Sibinelli ◽  
Juliana Tavares Neves Bernardi ◽  
Paula de Moura Piovesana ◽  
...  
Keyword(s):  
High Risk ◽  
Respiratory Mechanics ◽  
Abdominal Pressure ◽  
High Risk Patients ◽  
Compartmental Syndrome ◽  
Abdominal Hypertension ◽  
Risk Patients ◽  
Abdominal Compartmental Syndrome ◽  
Positive Expiratory Pressure

scholarly journals Case series of acute peritoneal dialysis in the prone position for acute kidney injury during the Covid-19 pandemic: Prone to complications?

2021 ◽  
pp. 089686082098367
Author(s):  
Qandeel H Soomro ◽  
Vikramjit Mukherjee ◽  
Richard Amerling ◽  
Nina Caplin
Keyword(s):  
Acute Kidney Injury ◽  
Peritoneal Dialysis ◽  
Prone Position ◽  
Distress Syndrome ◽  
Respiratory Mechanics ◽  
Case Series ◽  
Kidney Injury ◽  
Abdominal Pressure ◽  
Prone Positioning ◽  
Respiratory System Compliance

Patients with kidney failure and acute respiratory distress syndrome (ARDS) requiring prone position have not been candidates for peritoneal dialysis (PD) due to concern with increased intra-abdominal pressure, reduction in respiratory system compliance and risks of peritoneal fluid leaks. We describe our experience in delivering acute PD during the surge in Covid-19 acute kidney injury (AKI) in the subset of patients requiring prone positioning. All seven patients included in this report were admitted to the intensive care unit with SARS-CoV-2 infection leading to ARDS, AKI and multisystem organ failure. All required renal replacement therapy, and prone positioning to improve ventilation/perfusion mismatch. All seven were able to continue PD despite prone positioning without any detrimental effects on respiratory mechanics or the need to switch to a different modality. Fluid leakage was noted in 71% of patients, but mild and readily resolved. We were able to successfully implement acute PD in ventilator-dependent prone patients suffering from Covid-19-related AKI. This required a team effort and some modifications in the conventional PD prescription and delivery.

Influence of intra-abdominal pressure on the flow of chronic colostasis for children

2016 ◽  
Vol 52-53 (3-4) ◽  
pp. 62-67
Author(s):  
V.S. Konoplytsky ◽  
◽  
O.O. Lukiyanets ◽  
Keyword(s):  
Abdominal Pressure
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