Information de reference pour ce titreAccession Number: | 00008506-201701000-00003.
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Author: | Kim, Eugene MD; Kim, Hyun-Chang MD; Lim, Young-Jin MD, PhD; Kim, Chi-Heon MD, PhD; Sohn, Seil MD; Chung, Chun-Kee MD, PhD; Kim, Hyoung-Jun MD; Kang, Hyun MD, PhD; Park, Hee-Pyoung MD, PhD
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Institution: | Departments of (*)Anesthesiology and Pain Medicine (++)Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine ([S])Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul (+)Department of Anesthesiology and Pain Medicine, Keimyung University Dongsan Hospital, Daegu, South Korea
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Title: | |
Source: | Journal of Neurosurgical Anesthesiology. 29(1):14-20, January 2017.
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Abstract: | Background: Positional apparatuses used for the prone position can affect intra-abdominal pressure (IAP). In this study, we compared the IAP after changing to the prone position and applying various positive end-expiratory pressure (PEEP) levels among 3 prone positional apparatuses.
Methods: A total of 108 healthy euvolemic patients undergoing elective prone spinal surgery were divided into 3 groups based on the positional apparatus used: the Jackson spinal table was used in group J (n=36), the Wilson frame in group W (n=36), and chest rolls in group C (n=36). The IAP was measured 2 minutes after application of 0, 3, 6, and 9 cm H2O of PEEP.
Results: The IAP in the supine position was 6.4+/-3.0, 5.9+/-2.8, and 7.1+/-2.5 mm Hg in groups J, C, and W, respectively. After the supine-to-prone positional change, the IAP in the prone position was significantly lower in group J than in groups C and W (2.7+/-2.9 vs. 8.9+/-4.0 and 12.9+/-4.3 mm Hg, P<0.01). In the prone position, a PEEP of 9 cm H2O increased the IAP from baseline (zero PEEP) by 1.5+/-1.3, 1.6+/-1.3, and 1.7+/-1.0 mm Hg in groups J, C, and W, respectively.
Conclusions: The IAP in the prone position was significantly lower using the Jackson table compared with the Wilson frame and chest rolls. A PEEP up to 9 cm H2O can be safely used in healthy euvolemic patients undergoing prone spinal surgery without a clinically significant increase in IAP, irrespective of the type of prone positional apparatus.
Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved
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Author Keywords: | intra-abdominal pressure; prone position; positive end-expiratory pressure.
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References: | 1. DePasse JM, Palumbo MA, Haque M, et al.. Complications associated with prone positioning in elective spinal surgery. World J Orthop. 2015;6:351-359.
2. Han IH, Son DW, Nam KH, et al.. The effect of body mass index on intra-abdominal pressure and blood loss in lumbar spine surgery. J Korean Neurosurg Soc. 2012;51:81-85.
3. Hedenstierna G, Larsson A. Influence of abdominal pressure on respiratory and abdominal organ function. Curr Opin Crit Care. 2012;18:80-85.
4. Kirkpatrick AW, Pelosi P, De Waele JJ, et al.. Clinical review: intra-abdominal hypertension: does it influence the physiology of prone ventilation? Crit Care. 2010;14:232.
5. Yi M, Leng Y, Bai Y, et al.. The evaluation of the effect of body positioning on intra-abdominal pressure measurement and the effect of intra-abdominal pressure at different body positioning on organ function and prognosis in critically ill patients. J Crit Care. 2012;27:e221-e226.
6. Bhardwaj A, Long DM, Ducker TB, et al.. Neurologic deficits after cervical laminectomy in the prone position. J Neurosurg Anesthesiol. 2001;13:314-319.
7. Mathai KM, Kang JD, Donaldson WF, et al.. Prediction of blood loss during surgery on the lumbar spine with the patient supported prone on the Jackson table. Spine J. 2012;12:1103-1110.
8. Torquato JA, Lucato JJ, Antunes T, et al.. Interaction between intra-abdominal pressure and positive-end expiratory pressure. Clinics (Sao Paulo). 2009;64:105-112.
9. Sussman AM, Boyd CR, Williams JS, et al.. Effect of positive end-expiratory pressure on intra-abdominal pressure. South Med J. 1991;84:697-700.
10. Soler Morejon Cde D, Tamargo Barbeito TO. Effect of mechanical ventilation on intra-abdominal pressure in critically ill patients without other risk factors for abdominal hypertension: an observational multicenter epidemiological study. Ann Intensive Care. 2012;2(suppl 1):S22.
11. Reintam Blaser A, Parm P, Kitus R, et al.. Risk factors for intra-abdominal hypertension in mechanically ventilated patients. Acta Anaesthesiol Scand. 2011;55:607-614.
12. Brower RG, Matthay MA, Morris A, et al.. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. New Engl J Med. 2000;342:1301-1308.
13. Kron IL, Harman PK, Nolan SP. The measurement of intra-abdominal pressure as a criterion for abdominal re-exploration. Ann Surg. 1984;199:28-30.
14. Tusman G, Sipmann FS, Bohm SH. Rationale of dead space measurement by volumetric capnography. Anesth Analg. 2012;114:866-874.
15. Akinci IO, Tunali U, Kyzy AA, et al.. Effects of prone and jackknife positioning on lumbar disc herniation surgery. J Neurosurg Anesthesiol. 2011;23:318-322.
16. Casati A, Salvo I, Torri G, et al.. Arterial to end-tidal carbon dioxide gradient and physiological dead space monitoring during general anaesthesia: effects of patients' position. Minerva Anestesiol. 1997;63:177-182.
17. Pelosi P, Croci M, Calappi E, et al.. Prone positioning improves pulmonary function in obese patients during general anesthesia. Anesth Analg. 1996;83:578-583.
18. Pelosi P, Croci M, Calappi E, et al.. The prone positioning during general anesthesia minimally affects respiratory mechanics while improving functional residual capacity and increasing oxygen tension. Anesth Analg. 1995;80:955-960.
19. Mure M, Domino KB, Lindahl SGE, et al.. Regional ventilation-perfusion distribution is more uniform in the prone position. J Appl Physiol. 2000;88:1076-1083.
20. Kamel I, Barnette R. Positioning patients for spine surgery: avoiding uncommon position-related complications. World J Orthop. 2014;5:425-443.
21. Lee LA, Roth S, Posner KL, et al.. The American Society of Anesthesiologists Postoperative Visual Loss Registry: analysis of 93 spine surgery cases with postoperative visual loss. Anesthesiology. 2006;105:652-659.
22. Schonauer C, Bocchetti A, Barbagallo G, et al.. Positioning on surgical table. Eur Spine J. 2004;13(suppl 1):S50-S55.
23. Takata M, Wise RA, Robotham JL. Effects of abdominal pressure on venous return: abdominal vascular zone conditions. J Appl Physiol (1985). 1990;69:1961-1972.
24. Park CK. The effect of patient positioning on intraabdominal pressure and blood loss in spinal surgery. Anesth Analg. 2000;91:552-557.
25. Rigamonti A, Gemma M, Rocca A, et al.. Prone versus knee-chest position for microdiscectomy: a prospective randomized study of intra-abdominal pressure and intraoperative bleeding. Spine (Phila Pa 1976). 2005;30:1918-1923.
26. Kotzampassi K, Paramythiotis D, Eleftheriadis E. Deterioration of visceral perfusion caused by intra-abdominal hypertension in pigs ventilated with positive end-expiratory pressure. Surg Today. 2000;30:987-992.
27. Guimaraes HP, Schneider AP, Leal PHR, et al.. Influence of the increase of positive end expiratory pressure (PEEP) on the intra-abdominal pressure. Intensive Care Med. 2003;29:S55.
28. Ashraf A, Conil JM, Georges B, et al.. Relation between ventilatory pressures and intra-abdominal pressure. Crit Care. 2008;12(suppl 2):P324.
29. Pelosi P, Quintel M, Malbrain ML. Effect of intra-abdominal pressure on respiratory mechanics. Acta Clin Belg. 2007;62(suppl 1):78-88.
30. Nam Y, Yoon AM, Kim YH, et al.. The effect on respiratory mechanics when using a Jackson surgical table in the prone position during spinal surgery. Korean J Anesthesiol. 2010;59:323-328.
31. Lynch S, Brand L, Levy A. Changes in lung thorax compliance during orthopedic surgery. Anesthesiology. 1959;20:278-282.
32. Palmon SC, Kirsch JR, Depper JA, et al.. The effect of the prone position on pulmonary mechanics is frame-dependent. Anesth Analg. 1998;87:1175-1180.
33. Maisch S, Reissmann H, Fuellekrug B, et al.. Compliance and dead space fraction indicate an optimal level of positive end-expiratory pressure after recruitment in anesthetized patients. Anesth Analg. 2008;106:175-181.
34. El-Baradey GF, El-Shamaa NS. Compliance versus dead space for optimum positive end expiratory pressure determination in acute respiratory distress syndrome. Indian J Crit Care Med. 2014;18:508-512.
35. Kuckelt W, Scharfenberg J, Mrochen H, et al.. Effect of PEEP on gas exchange, pulmonary mechanics, and hemodynamics in adult respiratory distress syndrome (ARDS). Intens Care Med. 1981;7:177-185.
36. Chiumello D, Cressoni M, Racagni M, et al.. Effects of thoraco-pelvic supports during prone position in patients with acute lung injury/acute respiratory distress syndrome: a physiological study. Crit Care. 2006;10:R87.
37. Sugerman H, Windsor A, Bessos M, et al.. Intra-abdominal pressure, sagittal abdominal diameter and obesity comorbidity. J Intern Med. 1997;241:71-79.
38. Lambert DM, Marceau S, Forse RA. Intra-abdominal pressure in the morbidly obese. Obes Surg. 2005;15:1225-1232.
39. Malbrain MLNG, Chiumello D, Pelosi P, et al.. Prevalence of intra-abdominal hypertension in critically ill patients: a multicentre epidemiological study. Intens Care Med. 2004;30:822-829.
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Language: | English.
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Document Type: | Clinical Investigations.
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Journal Subset: | Nursing. Clinical Medicine.
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ISSN: | 0898-4921
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NLM Journal Code: | bhu, 8910749
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DOI Number: | https://dx.doi.org/10.1097/ANA.0...- ouverture dans une nouvelle fenêtre
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