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Anaesthesiology Intensive Therapy
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1/2022
vol. 54
 
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abstract:
Original article

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

Adrian Regli
1, 2
,
Reoch Nanda
3
,
Jan P. Braun
4
,
Massimo Girardis
5
,
Martin Max
6
,
Manu L. Malbrain
7, 8
,
Bart L. De Keulenaer
1, 9

1.
Department of Intensive Care Medicine, Fiona Stanley Hospital, Murdoch, Australia
2.
School of Medicine, University of Notre Dame, Fremantle, Australia
3.
Department of Emergency, Royal Perth Hospital, Perth, Australia
4.
Department of Anaesthesiology and Intensive Care, Charité, Universitätsmedizin Berlin, Berlin, Germany
5.
University Hospital of Modena, University of Modena & Reggio Emilia, Modena, Italy
6.
Department of Intensive Care Medicine, Centre Hospitalier, Luxembourg
7.
First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Poland
8.
International Fluid Academy, Lovenjoel, Belgium
9.
School of Surgery, The University of Western Australia, Crawley WA 6009, Australia
Anaesthesiol Intensive Ther 2022; 54, 1: 30–33
Online publish date: 2022/02/16
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Background
Non-invasive ventilation is a well-established treatment modality in patients with respiratory failure of different aetiologies. A previous case report described how non-invasive ventilation caused gastric distension and intra-abdominal hypertension with subsequent cardio-respiratory arrest and clinical recovery following resuscitative efforts including gastric decompression with a nasogastric tube.

Methods
The aim of this prospective multicentre observational study was to assess the effect of non-invasive ventilation on intra-abdominal pressure. Following informed consent, intra-abdominal pressure and PaCO2 were measured before and after the application of non-invasive ventilation for up to three days in critically ill patients requiring non-invasive ventilation.

Results
Thirty-five patients were enrolled; mean (±SD) age of 67.8 (±12.5) years, median (interquartile range) body mass index of 27.9 (24.5–30.0) kg m–2, Acute Physiology and Chronic Health Evaluation II score of 15.8 (±6.4). On admission and after 24 hours of non-invasive ventilation, intra-abdominal pressure was 11.0 (7.5–15.0) mm Hg and 11.0 (8.5–14.5) mm Hg (P = 0.82) and PaCO2 was 44.4 (±11.4) mm Hg and 51.3 (±14.3) mm Hg (P = 0.19), respectively.

Conclusions
The application of non-invasive ventilation was not associated with an increase in intra-abdominal pressure over 72 hours in this small observational study. Thus, it appears that intra-abdominal pressure does not frequently increase when applying non-invasive ventilation in critically ill patients with respiratory failure.

keywords:

chronic obstructive pulmonary disease, intra-abdominal hypertension, non-invasive ventilation, intra-abdominal pressure

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