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| 1 | Effect of intra-abdominal pressure on respiratory function in patients undergoing ventral hernia repair显示文摘AIM: To determine the influence of intra-abdominal pressure(IAP) on respiratory function after surgical repair of ventral hernia and to compare two different methods of IAP measurement during the perioperative period. METHODS: Thirty adult patients after elective repair of ventral hernia were enrolled into this prospective study.IAP monitoring was performed via both a balloontipped nasogastric probe [intragastric pressure(IGP), Ci MON, Pulsion Medical Systems, Munich, Germany] and a urinary catheter [intrabladder pressure(IBP), Uno Meter Abdo-Pressure Kit, Uno Medical, Denmark] on five consecutive stages:(1) after tracheal intubation(AI);(2) after ventral hernia repair;(3) at the end of surgery;(4) during spontaneous breathing trial through the endotracheal tube; and(5) at 1 h after tracheal extubation. The patients were in the complete supine position during all study stages.RESULTS: The IAP(measured via both techniques) increased on average by 12% during surgery compared to AI(P < 0.02) and by 43% during spontaneous breathing through the endotracheal tube(P < 0.01). In parallel, the gradient between РаСО2 and Et CO2 [Р(а-et)CO2] rose significantly, reaching a maximum during the spontaneous breathing trial. The PаO2/Fi O2 decreased by 30% one hour after tracheal extubation(P = 0.02). The dynamic compliance of respiratory system reduced intraoperatively by 15%-20%(P < 0.025). At all stages, we observed a significant correlation between IGP and IBP(r = 0.65-0.81, P < 0.01) with a mean bias varying from-0.19 mm Hg(2SD 7.25 mm Hg) to-1.06 mm Hg(2SD 8.04 mm Hg) depending on the study stage. Taking all paired measurements together(n = 133), the median IGP was 8.0(5.5-11.0) mm Hg and the median IBP was 8.8(5.8-13.1) mm Hg. The overall r2 value( n = 30) was 0.76(P < 0.0001). Bland and Altman analysis showed an overall bias for the mean values per patient of 0.6 mm Hg(2SD 4.2 mm Hg) with percentage error of 45.6%. Looking at changes in IAP between the different study stages, we found an excellent concordance coefficient of 94.9% comparing IBP and IGP( n = 117).CONCLUSION: During ventral hernia repair, the IAP rise is accompanied by changes in Р(а-et)CO2 and PаO2/Fi O2-ratio. Estimation of IAP via IGP or IBP demonstrated excellent concordance. | Konstantin M Gaidukov Elena N Raibuzhis Ayyaz Hussain Alexey Y Teterin Alexey A Smetkin Vsevolod V Kuzkov Manu LNG Malbrain Mikhail Y Kirov | 2013 | World Journal of Critical Care Medicine2013，2，2： | 2 |
| 2 | Thrombocytopenia and prognosis in intensive care 显示文摘 | Vanderschueren S De Weerdt A Malbrain M | 2000 | Crit Care Med2000，28，6： | 1 |
| 3 | Throm- eytopenia and prognosis in intensive eare显示文摘 | Vanderschueren S Weerdt A Malbrain M | 2000 | Crit Care Med2000，28，2： | 1 |
| 4 | Thrombocytopenia and prognosis in intensive care显示文摘 | Vanderschueren S De Weerdt A Malbrain M | 2000 | Crit Care Med2000，28，6： | 1 |
| 5 | Acute intestinal distress syndrome: the importance of intra-abdominal pressure 显示文摘 | Malbrain ML Vidts W Ravyts M | 2008 | Minerva Anestesiol2008，74，11： | 1 |
| 6 | Thrombocytopenia and prognosis in intensive care显示文摘 | Vanderschueren S Weerdt A Malbrain M | 2000 | Care Med2000，28，： | 1 |
| 7 | A pilot randomised controlled trial comparing reactive air and active alternating pressure mattresses in the prevention and treatment of pressure ulcers among medical ICU patients显示文摘 | Malbrain M Hendriks B Wijnands P | 2010 | J Tissue Viability2010，19，1： | 1 |
| 8 | Thrombocy-topenia and prognosis in intensive care显示文摘 | Vanderschueren S De Weerdt A Malbrain M | 2000 | Crit Care Med2000，28，6： | 1 |
| 9 | Thromcytopenia and prognosis in intensive care显示文摘 | Vanderschueren S Weerdt A Malbrain M | 2000 | Crit Care Med2000，28，： | 1 |
| 10 | Current insights in intra-abdominal hypertension and abdominal compartment syndrome显示文摘 | de Laet IE Malbrain M | 2007 | Med Intensiva2007，31，2： | 1 |
| 11 | Thromcytopenia and prognosis in intensive care 显示文摘 | VANDERSCHUEREN S WEERDT A MALBRAIN M | 2000 | Crit Care Med2000，28，： | 1 |
| 12 | Intra-abdominal hyperten?sion in the critically ill: it is time to pay attention显示文摘 | Malbrain M Deeren D De Potter TJ | 2005 | CUIT Opin Crit Care2005，11，2： | 1 |
| 13 | Results from the International conference of experts on intra-abdominal hypertension and abdominal compartment syndrome I definitions显示文摘 | Malbrain M L Cheatham M L Kirkpatrick A | 2006 | Intensive Care Med2006，32，11： | 1 |
| 14 | Thrombocytopenia and prognosis in intensive care显示文摘 | Vanderschueren S De Weerdt A Malbrain M | 2000 | CritCare Med2000，28，6： | 1 |
| 15 | Cardiovascular implications of abdominal compartment syndrome 显示文摘 | Cheatham M Malbrain M | 2007 | Acta Clin Belg Suppl2007，1，1： | 1 |
| 16 | Decreased duration of mechanical ventilation when comparing analgesia-based sedation using remifentanil with standard hypnotic-based sedation for up to 10 days in intensive care unit patients:a randomised trial显示文摘 | Breen D Karabinis A Malbrain M | 2005 | Critical Care2005，9，3： | 1 |
| 17 | Thrombocytopenia and prognosis in intensive care 显示文摘 | Vanderschueren S De Weerdt A Malbrain M | 2000 | Crit Care Med2000，28，6： | 1 |
| 18 | Gastrointestinal symptoms during the first week of intensive care are associated with poor outcome: a prospective multicentre study显示文摘 | Reintam Blaser A Poeze M Malbrain ML | 2013 | Intensive Care Med2013，39，5： | 1 |
| 19 | Incidence and prog- nosis of intraabdominal hypertension in a mixed population of critically ill patients: a multiple-center epidemiological study显示文摘 | Malbrain M L Chiumello D Pelosi P | 2005 | Crit Care Med2005，33，2： | 1 |
| 20 | Intra-abdominal hypertension:evolving concepts显示文摘 | Malbrain M L De laet I E | 2009 | Clin Chest Med2009，30，1： | 1 |
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