Airway Pressures as Surrogate Estimates of Intra-abdominal Pressure

    Authors

    A. Bunnell;M. L. Cheatham

    Comments

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    Abbreviated Journal Title

    Am. Surg.

    Keywords

    ABDOMINAL COMPARTMENT SYNDROME; CRITICALLY-ILL PATIENTS; INTERNATIONAL-CONFERENCE; CLINICAL EXAMINATION; HYPERTENSION; GASTROSCHISIS; DEFINITIONS; CLOSURE; EXPERTS; Surgery

    Abstract

    Intra-abdominal pressure (IAP) measurements are essential to the diagnosis and management of patients with intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Peak inspiratory pressure (PIP), plateau pressure (Pplat), and mean airway pressure (Paw) are used by some surgeons as surrogate estimates of IAP during abdominal closure. Thirty mechanically ventilated surgical/trauma patients with risk factors for IAH/ACS underwent simultaneous triplicate measurements of PIP, Pplat, Paw, and IAP. PIP, Pplat, and Paw were compared with IAP using both coefficient of determination and Bland and Altman analysis. The coefficient of determination for each airway pressure in predicting change in IAP was: PIP 5 per cent (P = 0.24), Pplat 17 per cent (P = 0.02), and Paw 15 per cent (P = 0.03). Bland and Altman analysis identified that marked variability exists between airway pressure and IAP measurements: PIP 19.3 +/- 18.7 mmHg, Pplat 11.1 +/- 13.7 mmHg, and Paw 2.0 +/- 9.8 mmHg. Airway pressures do not accurately reflect IAP and cannot be substituted for IAP measurements in patients at risk for IAH/ACS.

    Journal Title

    American Surgeon

    Volume

    81

    Issue/Number

    1

    Publication Date

    1-1-2015

    Document Type

    Article

    Language

    English

    First Page

    81

    Last Page

    85

    WOS Identifier

    WOS:000354894000034

    ISSN

    0003-1348

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