Intra-Abdominal Pressure and the Morbidly Obese Patients: The Effect of Body Mass Index

Wilson, Alison; Longhi, James J.; Goldman, Charles D.; McNatt, Stephen

doi:10.1097/ta.0b013e3181e05a79

Cited by 50 publications

(36 citation statements)

References 22 publications

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“…We found that AWT during late inspiration was higher than that during late expiration in both positions, which is consistent with the observation of Cheatham et al [14] Vasquez and colleagues [15] reported that IAP gradually increased as body position was elevated. This finding was similar to that of Wilson et al [17] However, we found that the AWT of the 30° supine position was lower than that of the supine position. We believe that when the head was raised, the abdominal wall muscles relaxed and the AWT decreased.…”

Section: Discussionsupporting

confidence: 78%

“…Sugerman et al [16] compared the IAP values of non-obese and obese people and found that they were higher in the latter than in the former. Wilson et al [17] also reported similar findings that were incompatible with our observation in this study. We speculated that this was associated with the BMI range of the study objects: BMI in the study of Wilson et al [17] were all >25 and some were even >40, but BMI in our study was relatively lower.…”

Section: Discussioncontrasting

confidence: 57%

“…Wilson et al [17] also reported similar findings that were incompatible with our observation in this study. We speculated that this was associated with the BMI range of the study objects: BMI in the study of Wilson et al [17] were all >25 and some were even >40, but BMI in our study was relatively lower. In future studies, the numbers of observed patients should be increased and BMI should be included to investigate the effects of BMI on IAP and AWT.…”

Section: Discussioncontrasting

confidence: 57%

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Noninvasive monitoring of intra-abdominal pressure by measuring abdominal wall tension

Chen¹,

Yan²,

Chen³

et al. 2015

World Journal of Emergency Medicine

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BACKGROUND: Noninvasive monitoring of intra-abdominal pressure (IAP) by measuring abdominal wall tension (AWT) was effective and feasible in previous postmortem and animal studies. This study aimed to investigate the feasibility of the AWT method for noninvasively monitoring IAP in the intensive care unit (ICU). METHODS:In this prospective study, we observed patients with detained urethral catheters in the ICU of Shanghai Tenth People's Hospital between April 2011 and March 2013. The correlation between AWT and urinary bladder pressure (UBP) was analyzed by linear regression analysis. The effects of respiratory and body position on AWT were evaluated using the paired samples t test, whereas the effects of gender and body mass index (BMI) on baseline AWT (IAP<12 mmHg) were assessed using one-way analysis of variance. RESULTS:A total of 51 patients were studied. A significant linear correlation was observed between AWT and UBP (R=0.986, P<0.01); the regression equation was Y=-1.369+9.57X (P<0.01). There were signifi cant differences among the different respiratory phases and body positions (P<0.01). However, gender and BMI had no signifi cant effects on baseline AWT (P=0.457 and 0.313, respectively). CONCLUSIONS:There was a signifi cant linear correlation between AWT and UBP and respiratory phase, whereas body position had signifi cant effects on AWT but gender and BMI did not. Therefore, AWT could serve as a simple, rapid, accurate, and important method to monitor IAP in critically ill patients.

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Section: Discussionsupporting

confidence: 78%

Section: Discussioncontrasting

confidence: 57%

Section: Discussioncontrasting

confidence: 57%

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Noninvasive monitoring of intra-abdominal pressure by measuring abdominal wall tension

Chen¹,

Yan²,

Chen³

et al. 2015

World Journal of Emergency Medicine

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“…46 With regard to the possible relationship of body weight and intra-abdominal pressure, body weight was not different in patients with and BMI in acute respiratory distress syndrome | 117 without intra-abdominal hypertension 30 as a result of the minimal impact on the intra-abdominal pressure from 0.01 to 0.02 kPa for each 1 kg m −2 . 47 In obese ARDS patients, we did not find a difference in the intra-abdominal pressure when compared with subjects of normal body weight. In contrast to previous studies that reported a significant increase in chest wall elastance, in our study chest wall and lung elastance were not affected by the body weight, suggesting that the increase in body mass acts simply as an 'external' inspiratory loading force that causes a rightward shift of the chest wall and lung pressure volume curve without altering their characteristics.…”

Section: Respiratory Mechanicsmentioning

confidence: 72%

Effect of body mass index in acute respiratory distress syndrome

Chiumello

Colombo

Algieri

et al. 2016

British Journal of Anaesthesia

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Background: Obesity is associated in healthy subjects with a great reduction in functional residual capacity and with a stiffening of lung and chest wall elastance, which promote alveolar collapse and hypoxaemia. Likewise, obese patients with acute respiratory distress syndrome (ARDS) could present greater derangements of respiratory mechanics than patients of normal weight. Methods: One hundred and one ARDS patients were enrolled. Partitioned respiratory mechanics and gas exchange were measured at 5 and 15 cm H 2 O of PEEP with a tidal volume of 6-8 ml kg −1 of predicted body weight. At 5 and 45 cm H 2 O of PEEP, two

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“…With obese patients, the IAP is elevated compared with those with a normal BMI. 16,28,30 The risk of incisional hernia is also higher in obese patients. 26 Thus, these considerations must be factored into the preoperative assessment of patients with previous abdominal surgery who are at risk for incisional hernia and subsequent small-bowel obstruction.…”

Section: Discussionmentioning

confidence: 99%

Abdominal complications following posterior spinal fusion in patients with previous abdominal surgeries

Shih¹,

Slimack²,

Roy³

et al. 2011

FOC

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Perioperative abdominal complications associated with spine surgery are rare. Although most known abdominal complications occur in conjunction with anterior spinal fusions, there is a paucity of reports reviewing abdominal complications occurring with posterior spinal fusions. The authors review 4 patients who experienced a perioperative abdominal complication following a posterior spinal fusion. In each of these patients, a history of abdominal surgery is present. Given the physiological changes that occur with surgery in the prone position, patients with previous abdominal surgeries are at risk for developing abdominal complications in the perioperative period.

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Intra-Abdominal Pressure and the Morbidly Obese Patients: The Effect of Body Mass Index

Cited by 50 publications

References 22 publications

Noninvasive monitoring of intra-abdominal pressure by measuring abdominal wall tension

Noninvasive monitoring of intra-abdominal pressure by measuring abdominal wall tension

Effect of body mass index in acute respiratory distress syndrome

Abdominal complications following posterior spinal fusion in patients with previous abdominal surgeries

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