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The effect of reference position versus right lateral position on the intra-abdominal pressure in mechanically ventilated patients

机译:参考位置与右侧位置对机械通气患者腹腔内压力的影响

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Background and objective: Intra-abdominal hypertension (IAH) is a frequent plentiful problem in patients admitted to critical care units. It ranges from a surge incidence of morbidity and mortality to a particular need for nursing health care, so recognition of the occurrence of IAH is a very critical issue for critical care nurses and physician. This study aimed to recognize the effects of various body position with the various head of bed elevation on the intra-abdominal pressure (IAP) in patients with mechanical ventilation.Methods: Design: A non-randomized, prospective observational study was used. Setting: Trauma and general intensive care units at Assuit University Hospitals. Method: In a prospective observational study, during the third day of mechanical ventilation, 60 patients were screened for IAP via a urinary catheter, in two various body positions in three separate degrees of the head of the bed (HOB) elevation (0o, 15o, and 30o). The position was changed at least 4 hours apart over a 24-h period.Results: In lateral recumbence, IAP measurements were significantly elevated compared to supine position, they were 19.70 ± 3.09 mmHg versus 16.00 ± 3.14 (p .001), 22.80 ± 3.56 mmHg versus 19.03 ± 2.95 (p .001), and 26.08 ± 3.59 mmHg versus 21.46 ± 2.90 versus (p .001) at 0o, 15o, and 30o respectively. The mean of IAP difference was 3.7 ± 3.0 mmHg at 0o, 3.8 ± 1.00 mmHg at 15o, and 5.5 ± 1.01 mmHg at 30 o (p .005).Conclusions: IAP reading is significantly elevated by changing from supine to lateral position especially with HOB elevation and significantly correlated with mortality rate in patients with mechanical ventilation.
机译:背景与目的:重症监护病房的患者经常发生腹内高压(IAH)问题。其范围从发病率和死亡率的高发率到对护理保健的特殊需求,因此,对于重症监护护士和医师而言,对IAH发生的认识是一个非常关键的问题。这项研究的目的是认识到机械床通气患者的各种床头抬高姿势对腹腔内压力(IAP)的影响。方法:设计:采用非随机的前瞻性观察性研究。地点:Assuit大学医院的创伤科和普通重症监护室。方法:在一项前瞻性观察性研究中,在机械通气的第三天,通过导尿管筛查了60位患者的IAP,分别位于床头(HOB)抬高角度(0o,15o)的三个不同角度的两个不同的身体位置,和30o)。在24小时内至少每隔4小时更改一次位置。结果:侧卧时,与仰卧位相比,IAP测量值显着升高,分别为19.70±3.09 mmHg和16.00±3.14(p <.001),22.80在0o,15o和30o分别为±3.56 mmHg与19.03±2.95(p <.001)和26.08±3.59 mmHg与21.46±2.90与(p <.001)。 IAP的平均值在0o时为3.7±3.0 mmHg,在15o时为3.8±1.00 mmHg,在30o时为5.5±1.01 mmHg(p <.005)。机械通气患者的HOB升高与死亡率显着相关。

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