Measuring Intra-abdominal Pressure during Spontaneous Breathing Trial: Does It Help?
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2016, Vol 18, Issue 7
Abstract
Background: Respiratory system impairment may be caused by an increase of the intra-abdominal pressure (IAP). Aim of Work: To assess the role of measuring intra-abdominal pressure in predicting successful weaning from mechanical ventilation. Methods: 124 patients with acute respiratory failure ARF fulfilling the criteria for weaning were included. Each underwent a 1-hour spontaneous breathing trial (SBT). All clinical, respiratory parameters and mechanics were recorded. IAP was measured using Kron`s technique at the beginning and every 15 minutes till the end of SBT. The mean of IAP during SBT was calculated. Results: Of 124 patients included in the study, 94 patients achieved successful SBT and extubation, while 31 patients needed re-intubation within 48 hours. Mean IAP was lower in patients that achieved successful SBT compared to patients who didn`t, 7.25 ± 2.28 vs 9.96 ± 2.6, p value < 0.001. Moreover, patients who needed re-intubation within 48 hours had higher mean IAP compared to patients who didn`t, 9.96 ± 1.4 vs 5.92 ± 1.17, P value < 0.001. The cut-off value of mean IAP that predict the need for re-intubation was 8.9 cm H2O with sensitivity and specificity measuring 80% and 52% respectively. The Area Under the Curve (AUC) was 0.97. With multivariate regression analysis, mean IAP was an independent predictor of SBT failure (odds ratio (OR) 1.46, 95% confidence interval (CI) 1.62 to 1.839, p value 0.001). Using Spearman's rank correlation coefficient, it was found that mean IAP was positively correlated with auto ,positive end expiratory pressure, PEEP that measured at the beginning and at the end of SBT, and admission APACHE II score, with correlation coefficient measuring 0.515, 0.595, and 0.4 respectively.
Authors and Affiliations
Mohamed Omar Elghonemi, Mohamed Hamdi Saleh
Keywords
Related Articles
- EP ID EP341029
- DOI 10.9734/BJMMR/2016/28953
- Views 48
- Downloads 0
Role of Free Radicals and Common Antioxidants in Oral Health, an Update
Free radicals have been implicated in the etiology of large number of major diseases. They can adversely alter many crucial biological molecules leading to loss of form and function. Such undesirable changes in the body...
Tibial Blowout”- A Complication of Arthroscopic Anterior Cruciate Ligament Reconstruction
The reconstruction of anterior cruciate ligament (ACL) has become the standard of care for a torn ACL in active, young athletes. Various technical complications during the surgery are documented. Of the complications per...
Hepatitis C Virus in HIV Co-morbid Pregnancies in Jos, Nigeria
Background: Hepatitis C virus (HCV) and Human immunodeficiency virus (HIV) infections are of medical significance. Objective: The study was designed to determine the rates and risk factors for HCV infection among HIV pos...
Imaging and Pathologic Features of the Common Hepatic Focal Lesions
Background and Study Aims: Focal liver lesions are considerably detected in every day practice. Radiological imaging has a significant role in the detection and follow up of hepatic focal lesions. At times, the pathologi...
Attitudes of Patients to Medical Students in the Gynaecology Clinic: A Nigerian Experience
Background: Out-patient clinics are very important in medical students’ education. Aim: This study was undertaken to determine the attitudes of patients to the participation of medical students in their consultation in t...