The effect of non-invasive ventilation  on intra-abdominal pressure

Regli, Adrian; Nanda, Reoch; Braun, J.; Girardis, Massimo; Max, M.; Malbrain, Manu; Keulenaer, Bart De

doi:10.5114/ait.2022.113488

Cited by 8 publications

(5 citation statements)

References 14 publications

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“…Previously, case reports have described IAH and ACS developing in patients requiring NIV. In a clinical study in 35 patients receiving NIV, the use of NIV was not associated with an increase in IAP after 24 h of NIV, also in patients requiring pressure support above 10 cmH 2 O [32]. On the basis of this finding, IAH should not be considered a contraindication to start NIV when considered necessary.…”

Section: Conditions Commonly Associated With Intra-abdominal Hyperten...mentioning

confidence: 81%

Intra-abdominal hypertension and abdominal compartment syndrome

Waele

2022

Current Opinion in Critical Care

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Purpose of reviewIntra-abdominal hypertension (IAH) has been acknowledged as an important contributor to organ dysfunction in critically ill patients, both in surgical and medical conditions. As our understanding of the pathophysiology evolves, risk factors are better recognized, preventive measures can now be implemented and therapeutic interventions tailored to the physiology of the patient. In the current review, we want to highlight developing insights in the epidemiology and treatment of patients with IAH and ACS. Recent findingsThe impact of IAH and ACS on kidney function and other outcomes continues to draw attention in recent studies. New methods for IAP measurement are under development, and the search for biomarkers to detect IAH or ACS continues. In conditions wherein IAH and ACS are common, recent studies allow better prevention and treatment of these conditions, based on the contemporary ICU management consisting of IAP measurement, judicious fluid resuscitation and decompressive laparotomy where necessary. Surgical treatment options including open abdomen therapy continue to be improved with demonstrable impact on outcomes.

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Section: Conditions Commonly Associated With Intra-abdominal Hyperten...mentioning

confidence: 81%

Intra-abdominal hypertension and abdominal compartment syndrome

Waele

2022

Current Opinion in Critical Care

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“…Numerous pathologies associated with gastric distension have been identified and reported to be associated with NIPPV, but to our knowledge, this is the first case in which NIPPV resulted in significant distension of an existing hiatal hernia to the point of mediastinal tamponade. Although Adrian Regli's research demonstrated that non-invasive ventilation was not correlated with an increase in intra-abdominal pressure during a 72-hour period [3], cases of postoperative air leakage during NIPPV support have been made. Jean-Lavaleur M et al described a case of gastric perforation with NIPPV; the patient had a full recovery after primary closure [4].…”

Section: Discussionmentioning

confidence: 99%

Noninvasive Positive Pressure Ventilation (NIPPV)-Associated Expanding Hiatal Hernia Causing Pulmonary Tamponade: A Case Report on Unusual Complication of NIPPV

Jain¹,

Mumtaz²,

Hussain³

et al. 2022

Cureus

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Numerous diseases related to gastric distension have been found and shown to be linked with noninvasive positive pressure ventilation (NIPPV). We describe the case of a 93-year-old female who came with progressively worsening shortness of breath that initially responded to NIPPV but subsequently deteriorated. Imaging revealed gaseous distension of a preexisting hiatal hernia with air-fluid levels and compressive effects on the left lower lobe of the lung. She was successfully managed using a conservative decompression strategy. This is the first case to our knowledge of NIPPV causing considerable distension of an existing hiatal hernia to the point of mediastinal tamponade.

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“…This study is the first to attempt validation of IAP rect measurements against the gold standard IAP ves in an ICU-setting [9]. The inclusion of sedated patients, in whom confounding variables are lower, and the strict protocol are strengths of this study [26]. However, the small sample size, the poor description of patient demographics, high drop-out rate and the incompletely performed protocol due to patient or technique related issues are weaknesses and may have underpowered our study results.…”

Section: Strengths and Limitations Of The Studymentioning

confidence: 99%

Is it feasible to measure intra-abdominal pressure using a balloon-tipped rectal catheter? Results of a validation study

Staelens

Heymans

Christiaens

et al. 2022

J Clin Monit Comput

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The gold standard to measure intra-abdominal pressure (IAP) is intra-vesical measurement via the urinary bladder. However, this technique is restricted in ambulatory settings because of the risk of iatrogenic urinary tract infections. Rectal IAP measurements (IAPrect) may overcome these limitations, but requires validation. This validation study compares the IAPrect technique against gold standard intra-vesical IAP measurements (IAPves). IAPrect using an air-filled balloon catheter and IAPves using Foley Manometer Low Volume were measured simultaneously in sedated and ventilated patients. Measurements were performed twice in different positions (supine and HOB 45° elevated head of bed) and with an external abdominal pressure belt. Sixteen patients were included. Seven were not eligible for analysis due to unreliable IAPrect values. IAPrect was significantly higher than IAPves for all body positions (p < 0.01) and the correlation between IAPves and IAPrect was poor and not significant in each position (p ≥ 0.25, R2 < 0.6, Lin’s CCC < 0.8, bias − 8.1 mmHg and precision of 5.6 mmHg with large limits of agreement between − 19 to 2.9 mmHg, high percentage error 67.3%, and low concordance 86.2%). Repeatability of IAPrect was not reliable (R = 0.539, p = 0.315). For both techniques, measurements with the external abdominal pressure belt were significantly higher compared to those without (p < 0.03). IAPrect has important shortcomings making IAP estimation using a rectal catheter unfeasible because the numbers cannot be trusted nor validated.

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The effect of non-invasive ventilation on intra-abdominal pressure

Cited by 8 publications

References 14 publications

Intra-abdominal hypertension and abdominal compartment syndrome

Intra-abdominal hypertension and abdominal compartment syndrome

Noninvasive Positive Pressure Ventilation (NIPPV)-Associated Expanding Hiatal Hernia Causing Pulmonary Tamponade: A Case Report on Unusual Complication of NIPPV

Is it feasible to measure intra-abdominal pressure using a balloon-tipped rectal catheter? Results of a validation study

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