Gastric and urinary bladder pressures correlate with intra-abdominal pressure in patients with morbid obesity

被引：0
作者：
Shadi Hamoud
Siham Abdelgani
Michal Mekel
Safa Kinaneh
Ahmad Mahajna
机构：
[1] Rambam Health Care Campus,Department of Internal Medicine E
[2] Technion– Israel Institute of Technology,Ruth & Bruce Rappaport Faculty of Medicine
[3] Rambam Health Care Campus,Department of Internal Medicine A
[4] Rambam Health Care Campus,Department of General Surgery
[5] Technion– Israel Institute of Technology,Department of Physiology, The Ruth & Bruce Rappaport Faculty of Medicine
来源：
Journal of Clinical Monitoring and Computing | 2022年 / 36卷
关键词：
Intra-abdominal pressure; Gastric pressure; Urinary bladder pressure; Laparoscopy;
D O I：
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学科分类号：
摘要：
Intra-abdominal pressure (IAP) affects cardio-respiratory and hemodynamic parameters and can be measured directly or indirectly by measuring gastric or urinary bladder pressure. The aim of this study was to investigate the correlation between IAP, gastric pressure and urinary bladder pressure in patients with morbid obesity, at normal and elevated levels of IAP in two positions. As well, to examine the effects of increasing IAP and patient's position on hemodynamic and respiratory parameters. Twelve patients undergoing laparoscopic bariatric surgery were included. IAP, gastric pressure, and urinary bladder pressure were measured while patients were in the supine position and after 45° anti-Trendelenburg tilt. Mean inspiratory pressure, peak inspiratory pressure, and tidal volume were recorded and assessed. In supine position; directly measured IAP was 9.1 ± 1.8 mmHg, compared to 10 ± 3.6 and 8.9 ± 2.9 mmHg in the stomach and bladder, respectively. Increasing IAP to 15 mmHg resulted in an increased gastric pressure of 17 ± 3.8 mmHg, and urinary bladder pressure of 14.8 ± 3.9 mmHg. Gastric and urinary bladder pressures strongly correlated with IAP (R = 0.875 and 0.847, respectively). With 45° anti-Trendelenburg tilt; directly measured IAP was 9.4 ± 2.2 mmHg, and pressures of 10.8 ± 3.8 mmHg and 9.2 ± 3.8 mmHg were measured in the stomach and the bladder, respectively. Increasing IAP to 15 mmHg resulted in elevating gastric and bladder pressures to 16.6 ± 5.3 and 13.3 ± 4 mmHg, respectively. Gastric and urinary bladder pressures had good correlation with IAP (R = 0.843 and 0.819, respectively). Changing patient position from supine to 45° anti-Trendelenburg position resulted in decreased mean and peak inspiratory pressures, and increased tidal volume. Basal IAP is high in patients with morbid obesity. IAP shows positive correlation to gastric and urinary bladder pressures at both normal and elevated levels of IAP. Anti-Trendelenburg tilt of mechanically ventilated morbidly obese patients resulted in favorable effects on respiratory parameters.
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页码：1021 / 1028
页数：7
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