Journal article
Commonly applied positive end-expiratory pressures do not prevent functional residual capacity decline in the setting of intra-abdominal hypertension: a pig model
Critical Care, Vol.14(4), R128
2010
Abstract
Introduction
Intra-abdominal hypertension is common in critically ill patients and is associated with increased morbidity and mortality. The optimal ventilation strategy remains unclear in these patients. We examined the effect of positive end-expiratory pressures (PEEP) on functional residual capacity (FRC) and oxygen delivery in a pig model of intra-abdominal hypertension.
Methods
Thirteen adult pigs received standardised anaesthesia and ventilation. We randomised three levels of intra-abdominal pressure (3 mmHg (baseline), 18 mmHg, and 26 mmHg) and four commonly applied levels of PEEP (5, 8, 12 and 15 cmH2O). Intra-abdominal pressures were generated by inflating an intra-abdominal balloon. We measured intra-abdominal (bladder) pressure, functional residual capacity, cardiac output, haemoglobin and oxygen saturation, and calculated oxygen delivery.
Results
Raised intra-abdominal pressure decreased FRC but did not change cardiac output. PEEP increased FRC at baseline intra-abdominal pressure. The decline in FRC with raised intra-abdominal pressure was partly reversed by PEEP at 18 mmHg intra-abdominal pressure and not at all at 26 mmHg intra-abdominal pressure. PEEP significantly decreased cardiac output and oxygen delivery at baseline and at 26 mmHg intra-abdominal pressure but not at 18 mmHg intra-abdominal pressure.
Conclusions
In a pig model of intra-abdominal hypertension, PEEP up to 15 cmH2O did not prevent the FRC decline caused by intra-abdominal hypertension and was associated with reduced oxygen delivery as a consequence of reduced cardiac output. This implies that PEEP levels inferior to the corresponding intra-abdominal pressures cannot be recommended to prevent FRC decline in the setting of intra-abdominal hypertension.
Details
- Title
- Commonly applied positive end-expiratory pressures do not prevent functional residual capacity decline in the setting of intra-abdominal hypertension: a pig model
- Authors/Creators
- A. Regli (Author/Creator) - Sir Charles Gairdner HospitalL.E. Hockings (Author/Creator) - Sir Charles Gairdner HospitalG.C. Musk (Author/Creator) - Murdoch UniversityB. Roberts (Author/Creator) - Sir Charles Gairdner HospitalB. Noffsinger (Author/Creator) - Sir Charles Gairdner HospitalB. Singh (Author/Creator) - Sir Charles Gairdner HospitalP.V. van Heerden (Author/Creator) - Sir Charles Gairdner Hospital
- Publication Details
- Critical Care, Vol.14(4), R128
- Publisher
- BioMed Central
- Identifiers
- 991005544345807891
- Copyright
- © 2010 Regli et a
- Murdoch Affiliation
- School of Veterinary and Biomedical Sciences
- Language
- English
- Resource Type
- Journal article
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
Source: InCites
Metrics
209 File views/ downloads
110 Record Views
InCites Highlights
These are selected metrics from InCites Benchmarking & Analytics tool, related to this output
- Collaboration types
- Domestic collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.216 Abdominal Surgery
- 1.216.1873 Abdominal Compartment Syndrome
- Web Of Science research areas
- Critical Care Medicine
- ESI research areas
- Clinical Medicine