Effect of intra-abdominal pressure on respiratory function in patients undergoing ventral hernia repair

摘要: AIM: To determine the influence of intra-abdominal pressure (IAP) on respiratory function after surgical repair ventral hernia and to compare two different methods IAP measurement during perioperative period. METHODS: Thirty adult patients elective were enrolled into this prospective study. monitoring was performed via both a balloon-tipped nasogastric probe [intragastric (IGP), CiMON, Pulsion Medical Systems, Munich, Germany] urinary catheter [intrabladder (IBP), UnoMeterAbdo-Pressure Kit, UnoMedical, Denmark] five consecutive stages: (1) tracheal intubation (AI); (2) repair; (3) at end surgery; (4) spontaneous breathing trial through endotracheal tube; (5) 1 h extubation. The in complete supine position all study stages. RESULTS: (measured techniques) increased average by 12% surgery compared AI (P < 0.02) 43% tube 0.01). In parallel, gradient between РаСО2 EtCO2 [Р(а-et)CO2] rose significantly, reaching maximum trial. PаO2/FiO2 decreased 30% one hour extubation = 0.02). dynamic compliance system reduced intraoperatively 15%-20% 0.025). At stages, we observed significant correlation IGP IBP (r 0.65-0.81, P 0.01) with mean bias varying from -0.19 mmHg (2SD 7.25 mmHg) -1.06 mm Hg 8.04 depending stage. Taking paired measurements together (n 133), median 8.0 (5.5-11.0) 8.8 (5.8-13.1) mmHg. overall r2 value 30) 0.76 0.0001). Bland Altman analysis showed an for values per patient 0.6 4.2 percentage error 45.6%. Looking changes found excellent concordance coefficient 94.9% comparing ΔIBP ΔIGP 117). CONCLUSION: During repair, rise is accompanied Р(а-et)CO2 PаO2/FiO2-ratio. Estimation or demonstrated concordance.