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Published on: June 25, 2013
Increasing abdominal pressure with and without PEEP: effects on intra-peritoneal, intra-organ and intra-vascular
Stephan M Jakob1, Rafael Knuesel, Jyrki J Tenhunen
1Department of Intensive Care Medicine, University Hospital Inselspital and University of Bern, Bern, Switzerland. stephan.jakob@insel.ch
Background:
Intra-organ and intra-vascular pressures can be used to estimate intra-abdominal pressure. The aim of this prospective, interventional study was to assess the effect of PEEP on the accuracy of pressure estimation at different measurement sites in a model of increased abdominal pressure.
Methods:
Catheters for pressure measurement were inserted into the stomach, urinary bladder, peritoneal cavity, pulmonary artery and inferior vena cava of 12 pigs. The pressures were recorded simultaneously at baseline, during 10 cm H20 PEEP, external abdominal pressure (7 kg weight) plus PEEP, external abdominal pressure without PEEP, and again under baseline conditions. RESULTS (MEAN +/- SD): PEEP alone increased diastolic pulmonary artery and inferior vena cava pressure but had no effect on the other pressures. PEEP and external abdominal pressure increased intraperitoneal pressure from 6 +/- 1 mm Hg to 9 +/- 2 mm Hg, urinary bladder pressure from 6 +/- 2 mm Hg to 11 +/- 2 mm Hg (p = 0.012), intragastric pressure from 6 +/- 2 mm Hg to 11 +/- 2 mm Hg (all p
Conclusions:
Our data suggest that pressure changes induced by external abdominal pressure were not modified by changing PEEP between 0 and 10 cm H20.
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