The respiratory pressure-abdominal volume curve in a porcine model.
The respiratory pressure-abdominal volume curve in a porcine model.
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DOI：
10.1186/s40635-017-0124-7
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发表时间：
2017-12
影响因子：
3.5
通讯作者：
van Heerden PV
中科院分区：
文献类型：
--
作者：
Regli A;De Keulenaer BL;Singh B;Hockings LE;Noffsinger B;van Heerden PV
增加腹腔内容积（IAV）可导致腹腔内高压（IAH）或腹腔间隔室综合征。两者都与发病率和死亡率上升有关。IAH可增加气道压力并损害通气。增加的IAV和气道压力之间的关系尚不清楚。因此，我们评估了增加IAV对气道和腹内压（IAP）的影响。7头猪（41.4 +/-8.5 kg）接受标准化麻醉和机械通气。插入腹腔的乳胶球囊以1 L增量充盈，直至IAP超过40 cmH 2 O。测量气道峰压（pPAW）、呼吸顺应性和IAP（膀胱压）。计算腹部顺应性。不同的方程进行了测试，最好地描述了测得的压力-体积曲线。指数方程最好地描述了测得的压力-容积曲线。增加IAV以指数方式增加pPAW和IAP。IAP的增加与pPAW的平行增加相关，IAP向pPAW的传输约为40%。IAP越高，IAV对pPAW和IAP的影响越大。IAV对pPAW和IAP影响的指数性质意味着，在存在高等级IAH的情况下，IAV的小幅降低可导致气道和腹部压力的显著降低。相反，在IAP水平正常的情况下，IAV的大幅增加可能不会影响气道和腹部压力。本文的在线版本（doi：10.1186/s40635-017-0124-7）包含补充材料，可供授权用户使用。
Increasing intra-abdominal volume (IAV) can lead to intra-abdominal hypertension (IAH) or abdominal compartment syndrome. Both are associated with raised morbidity and mortality. IAH can increase airway pressures and impair ventilation. The relationship between increasing IAV and airway pressures is not known. We therefore assessed the effect of increasing IAV on airway and intra-abdominal pressures (IAP). Seven pigs (41.4 +/−8.5 kg) received standardized anesthesia and mechanical ventilation. A latex balloon inserted in the peritoneal cavity was inflated in 1-L increments until IAP exceeded 40 cmH2O. Peak airway pressure (pPAW), respiratory compliance, and IAP (bladder pressure) were measured. Abdominal compliance was calculated. Different equations were tested that best described the measured pressure-volume curves. An exponential equation best described the measured pressure-volume curves. Raising IAV increased pPAW and IAP in an exponential manner. Increases in IAP were associated with parallel increases in pPAW with an approximate 40% transmission of IAP to pPAW. The higher the IAP, the greater IAV effected pPAW and IAP. The exponential nature of the effect of IAV on pPAW and IAP implies that, in the presence of high grades of IAH, small reductions in IAV can lead to significant reductions in airway and abdominal pressures. Conversely, in the presence of normal IAP levels, large increases in IAV may not affect airway and abdominal pressures. The online version of this article (doi:10.1186/s40635-017-0124-7) contains supplementary material, which is available to authorized users.