Intensive Care Medicine

, Volume 34, Issue 9, pp 1632–1637 | Cite as

Respiratory variation of intra-abdominal pressure: indirect indicator of abdominal compliance?

  • Evelina Sturini
  • Andrea Saporito
  • Michael Sugrue
  • Michael J. A. Parr
  • Gillian Bishop
  • Antonio Braschi
Original
First Online:
Received:
Accepted:

Abstract

Objective

To assess if the observed respiratory cycle-related variation in intra-abdominal pressure is reliably quantifiable and a possible indirect indicator of abdominal compliance. Secondary issues were to assess the roles played by respiratory parameters in determining this oscillation and by patients’ position in increasing their intra-abdominal pressure.

Design and setting

Prospective observational study in a 26-bed medical-surgical intensive care unit.

Patients

Sixteen consecutive patients admitted to intensive care for at least 24 h, requiring mechanical ventilation and intra-abdominal pressure monitoring.

Measurements and results

Intra-abdominal pressure was measured with a modified Kron technique; its waveform was recorded and inspiratory and expiratory values were measured during five consecutive respiratory cycles for 5 days, both in the supine and the 30° head-up position. Inspiratory values were significantly higher than expiratory values (p = 0.001) and a correlation was found between their difference and intra-abdominal pressure basal values (p = 0.025). A positive linear relationship was shown between intra-abdominal pressure and the amplitude of its oscillation (r = 0.4), particularly in the subgroup of patients with intra-abdominal hypertension (r = 0.9). Intra-abdominal pressure was lower in patients supine than in the 30° head-up position (p = 0.001).

Conclusions

Respiratory cycle-related variations in intra-abdominal pressure were specifically investigated, quantified and shown as linearly increasing with end-expiratory intra-abdominal pressure; this phenomenon could be explained by patients’ abdominal compliance status. Supine posture should be an important consideration in specific patients affected by intra-abdominal hypertension.

Keywords

Intra-abdominal pressure Respiratory variation Mechanical ventilation Intra-abdominal hypertension Abdominal compliance Intensive care unit 
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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Evelina Sturini
    • 1
    • 4
  • Andrea Saporito
    • 1
  • Michael Sugrue
    • 2
  • Michael J. A. Parr
    • 1
  • Gillian Bishop
    • 1
  • Antonio Braschi
    • 3
  1. 1.Intensive Care Unit, Liverpool HospitalUniversity of New South WalesLiverpool, SydneyAustralia
  2. 2.Trauma Department, Liverpool HospitalUniversity of New South WalesLiverpool, SydneyAustralia
  3. 3.Cattedra di Anestesia e RianimazioneUniversità degli Studi di Pavia, IRCCS Policlinico San MatteoPaviaItaly
  4. 4.Verrua PoItaly

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