BACKGROUND: Intra-abdominal hypertension affects multiple organ systems. Current measurement standard requires supine positioning, which jeopardizes patient safety by increasing the risk for ventilator-associated pneumonia. This study evaluated the relationship between intra-abdominal pressure (IAP) and head-of-bed (HOB) positioning in critically ill intubated patients. METHODS: IAP measurements were performed using intravesical catheters with manometry. IAP was measured in a range of patient HOB increases from 0 degrees to 45 degrees. Multivariable generalized estimating equation modeling was performed to describe the relationship between IAP and HOB positioning. RESULTS: Three hundred (300) observations were performed on 37 patients. In multivariable modeling, HOB increase was significantly associated with IAP. Body mass index, positive end-expiratory pressure, temperature, and diagnostic category were significant in this model, whereas age and Riker sedation score were not. CONCLUSIONS: There is a significant, positive association between IAP and HOB positioning in critically ill patients. Clinically relevant changes in IAP occur at HOB increases >20 degrees.
BACKGROUND: Intra-abdominal hypertension affects multiple organ systems. Current measurement standard requires supine positioning, which jeopardizes patient safety by increasing the risk for ventilator-associated pneumonia. This study evaluated the relationship between intra-abdominal pressure (IAP) and head-of-bed (HOB) positioning in critically ill intubated patients. METHODS: IAP measurements were performed using intravesical catheters with manometry. IAP was measured in a range of patient HOB increases from 0 degrees to 45 degrees. Multivariable generalized estimating equation modeling was performed to describe the relationship between IAP and HOB positioning. RESULTS: Three hundred (300) observations were performed on 37 patients. In multivariable modeling, HOB increase was significantly associated with IAP. Body mass index, positive end-expiratory pressure, temperature, and diagnostic category were significant in this model, whereas age and Riker sedation score were not. CONCLUSIONS: There is a significant, positive association between IAP and HOB positioning in critically illpatients. Clinically relevant changes in IAP occur at HOB increases >20 degrees.
Authors: T Bein; M Bischoff; U Brückner; K Gebhardt; D Henzler; C Hermes; K Lewandowski; M Max; M Nothacker; T Staudinger; M Tryba; S Weber-Carstens; H Wrigge Journal: Anaesthesist Date: 2015-08 Impact factor: 1.041
Authors: Adrian B Cresswell; Wayel Jassem; Parthi Srinivasan; Andreas A Prachalias; Elizabeth Sizer; William Burnal; Georg Auzinger; Paolo Muiesan; Mohammed Rela; Nigel D Heaton; Matthew J Bowles; Julia A Wendon Journal: Ann Intensive Care Date: 2012-07-05 Impact factor: 6.925
Authors: Jan J De Waele; Inneke De Laet; Bart De Keulenaer; Sandy Widder; Andrew W Kirkpatrick; Adrian B Cresswell; Manu Malbrain; Zsolt Bodnar; Jorge H Mejia-Mantilla; Richard Reis; Michael Parr; Robert Schulze; Sonia Compano; Michael Cheatham Journal: Intensive Care Med Date: 2008-04-04 Impact factor: 17.440