Effect of body positioning on intra-abdominal pressure and abdominal perfusion pressure in critically ill patients

doi:10.3969/j.issn.1009-976X.2014.03.035

Abstract

Abstract:

Purpose: To observe the effects of body positioning on intra—abdominal hypertension（IAP） and abdominal perfusion pressure（APP）in critically ill patients. Methods: We investigated 78 patients admitted to ICU and measured their IAP from January 2013 to December 2013. IAP was measured with the patient head of bed (HOB) increases from 0°15°,30°to 45°via the bladder. APP were also calculated simultaneously. Results: In the patients of high IAP,Compared with IAP at supine position (bed of head=0°, 16.31 ±3.38 mmHg)， it showed significant difference at 30° (21.46±3.91 mmHg，P=0.001) and 45° (25.69±4.09 mmHg，P<0.001).And APP had significantly decreased at 45°（51.92±10.05mmHg，P=0.03）when compared with that at supine position (60.54 ±9.86 mmHg). In the patients of nomal IAP,Compared with IAP at supine position (bed of head=0°, 7.23±2.14mmHg)， it showed significant difference at 30° (11.17±3.24mmHg，P =0.002) and 45° (15.59±4.13 mmHg，P =0.001).And APP had significantly decreased at 45°（60.78±9.13mmHg，P=0.004） when compared with that at supine position (71.28 ±8.86 mmHg). Conclusion : Body positioning had effects on IAP and APP, IAP significantly increased and APP decreased when the patient's HOB was elevated. The potential contribution of body position in elevating IAP should be considered in critically ill patients.

Key words: Intra abdominal hypertension, Body position, Abdominal perfusion pressure

摘要： 【摘要】〓目的〓观察不同体位对腹内压及腹腔灌注压的影响。方法〓对2013年1月~2013年12月收治ICU的有腹内压监测适应征的78位患者分别在0°、15°、30°、45°采用测量膀胱压的方法监测腹内压,并计算腹腔灌注压。结果〓在腹内高压者,30°(21.46±3.91 mmHg, P=0.001)及45°(25.69±4.09 mmHg, P<0.001)时腹内压比0°(16.31±3.38 mmHg)时明显升高,而腹腔灌注压45°(51.92±10.05 mmHg,P=0.03)时明显低于0°(60.54±9.86 mmHg);在腹内压正常者30°(11.17±3.24 mmHg,P=0.002)及45°(15.59±4.13 mmHg, P=0.001)时腹内压比0°(7.23 ±2.14 mmHg)时明显升高,而腹腔灌注压45°(60.78±9.13 mmHg, P=0.004)时明显低于0°(71.28±8.86 mmHg)。结论〓危重病人不同体位对腹内压及腹腔灌注压有影响,床头角度越高,腹内压越高,腹腔灌注压越低,提示测量时应考虑体位的因素。

关键词: 腹内压, 腹腔灌注压, 体位

CLC Number:

R656

Wang Haiqin, Ma Jie. Effect of body positioning on intra-abdominal pressure and abdominal perfusion pressure in critically ill patients[J]. Lingnan Modern Clinics in Surgery, 2014, 14(03): 345-348.

汪海芹马婕. 不同体位对危重患者腹内压及腹腔灌注压的影响[J]. 岭南现代临床外科, 2014, 14(03): 345-348.

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