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| Effect of prone position ventilation on intra-abdominal pressure in patients with acute respiratory distress syndrome |
| Jiang Wen-fang, Wang Xiao-yuan, Hou Jin-zhen, Luo Jian-yu |
| Department of Intensive Care Unit, the People's Hospital of Liuzhou, Liuzhou 545006, China |
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Abstract Objective To investigate the effect of prone position ventilation (PV) on intra-abdominal pressure (IAP) in patients with moderate and severe acute respiratory distress syndrome (ARDS). Methods In this prospective randomized controlled trial, sixty patients with moderate and severe ARDS were selected randomly from the ICU. Twenty patients with normal IAP were normal IAP group (group A), 40 patients with IAP 12～15 mm Hg were classified as IAP I group (group B). All patients in group A received prone ventilation. The patients in group B were divided into prone position ventilation group (group B1) and supine position ventilation group (group B2) according to the digital randomization method, with 20 cases in each group. Oxygenation index (OI), airway platform pressure (Pplat), IAP, abdominal perfusion pressure (APP), mean arterial pressure (MAP), and blood lactate (Lac) were measured and compared before and 12 h after ventilation. Results In the normal IAP group, the OI at 12 h after prone position ventilation was significantly higher than that before ventilation (P<0.05), Pplat and Lac decreased compared with that before prone position ventilation (P<0.05), and there was no significant difference in IAP, APP and MAP (P>0.05); In B group, the OI after 12-hour ventilation of B1 group was higher than that of B2 group (P<0.05), Pplat and Lac significantly decreased (P<0.05), IAP of B1 group was higher than that before prone position ventilation and B2 group(P<0.05), but there was no significant difference in APP, MAP within each group and between groups before and after ventilation (P>0.05). In patients with different abdominal pressure, OI and Pplat in group A with normal abdominal pressure were improved more obviously than those in group B1 after 12 h of prone position ventilation. Conclusion Intra-abdominal hypertension（IAH） can reduce the effects of prone position ventilation, but in patients with moderate and severe ARDS complicated with mild IAH, although there is a slight increase in IAP after prone position ventilation, there is no significant effect on APP and hemodynamics, and it can significantly increase the oxygenation of patients.
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| About author:: Jiang Wen-fang, E-mail:wenfang1314@163.com |
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