Influence of intra-abdominal hypertension on the respiratory mechanics of critically ill adult patients with invasive mechanical ventilation
Objective: to describe the modifications in respiratory mechanics, the proposed ventilatory strategies and the correct positioning of critically ill adult patients with HIA and ACS with the requirement of IMV in the ICU. Data sources: the bibliographic search was carried out in Pubmed, Cochrane Libr...
Guardado en:
| Autores principales: | , , , |
|---|---|
| Formato: | Artículo revista |
| Lenguaje: | Español |
| Publicado: |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2020
|
| Materias: | |
| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/28148 |
| Aporte de: |
| id |
I10-R327-article-28148 |
|---|---|
| record_format |
ojs |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
intra-abdominal hypertension respiration, artificial respiratory mechanics intensive care units hipertensión intra-abdominal respiración artificial mecánica respiratoria unidades de cuidados intensivos hipertensão intra-abdominal respiração artificial mecânica respiratória unidades de terapia intensiva |
| spellingShingle |
intra-abdominal hypertension respiration, artificial respiratory mechanics intensive care units hipertensión intra-abdominal respiración artificial mecánica respiratoria unidades de cuidados intensivos hipertensão intra-abdominal respiração artificial mecânica respiratória unidades de terapia intensiva Vicente, Antonela Virgilio, Sacha Alexis Tocalini, Pablo Novo, María Noel Influence of intra-abdominal hypertension on the respiratory mechanics of critically ill adult patients with invasive mechanical ventilation |
| topic_facet |
intra-abdominal hypertension respiration, artificial respiratory mechanics intensive care units hipertensión intra-abdominal respiración artificial mecánica respiratoria unidades de cuidados intensivos hipertensão intra-abdominal respiração artificial mecânica respiratória unidades de terapia intensiva |
| author |
Vicente, Antonela Virgilio, Sacha Alexis Tocalini, Pablo Novo, María Noel |
| author_facet |
Vicente, Antonela Virgilio, Sacha Alexis Tocalini, Pablo Novo, María Noel |
| author_sort |
Vicente, Antonela |
| title |
Influence of intra-abdominal hypertension on the respiratory mechanics of critically ill adult patients with invasive mechanical ventilation |
| title_short |
Influence of intra-abdominal hypertension on the respiratory mechanics of critically ill adult patients with invasive mechanical ventilation |
| title_full |
Influence of intra-abdominal hypertension on the respiratory mechanics of critically ill adult patients with invasive mechanical ventilation |
| title_fullStr |
Influence of intra-abdominal hypertension on the respiratory mechanics of critically ill adult patients with invasive mechanical ventilation |
| title_full_unstemmed |
Influence of intra-abdominal hypertension on the respiratory mechanics of critically ill adult patients with invasive mechanical ventilation |
| title_sort |
influence of intra-abdominal hypertension on the respiratory mechanics of critically ill adult patients with invasive mechanical ventilation |
| description |
Objective: to describe the modifications in respiratory mechanics, the proposed ventilatory strategies and the correct positioning of critically ill adult patients with HIA and ACS with the requirement of IMV in the ICU.
Data sources: the bibliographic search was carried out in Pubmed, Cochrane Library and Google Scholar® without restriction of the language with publication date until July 31, 2019.
Study selection: adult patients with a requirement for IMV and diagnosis of HIA and / or ACS who have performed the ventilatory monitoring and patient positioning analysis. Laboratory studies on animals will be excluded.
Data extraction: the initial search identified 681 studies, of which 30 articles were included for data analysis.
Synthesis of data: patients with VMI requirement should be allowed to increase airway pressures and use of high PEEP; Only in specific cases could recruitment and prone maneuvering be applied to maintain adequate alveolar ventilation. Inverted Trendelemburg positioning is useful, as it improves respiratory mechanics and prevents abdominal compression.
Conclusions: alterations in respiratory mechanics produce a decrease in thoracic compliance, lung volumes and oxygenation disorders. The ventilatory strategy should consider Vt between 6-8 ml / kg according to predicted body weight, working pressure less than 14 cm H2O, plateau pressure of 30 cm H2O + PIA / 2 and sufficient levels of PEEP to prevent lung collapse in order to expiration. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2020 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/28148 |
| work_keys_str_mv |
AT vicenteantonela influenceofintraabdominalhypertensionontherespiratorymechanicsofcriticallyilladultpatientswithinvasivemechanicalventilation AT virgiliosachaalexis influenceofintraabdominalhypertensionontherespiratorymechanicsofcriticallyilladultpatientswithinvasivemechanicalventilation AT tocalinipablo influenceofintraabdominalhypertensionontherespiratorymechanicsofcriticallyilladultpatientswithinvasivemechanicalventilation AT novomarianoel influenceofintraabdominalhypertensionontherespiratorymechanicsofcriticallyilladultpatientswithinvasivemechanicalventilation AT vicenteantonela influenciadelahipertensionintraabdominalenlamecanicarespiratoriadepacientesadultoscriticamenteenfermosconventilacionmecanicainvasiva AT virgiliosachaalexis influenciadelahipertensionintraabdominalenlamecanicarespiratoriadepacientesadultoscriticamenteenfermosconventilacionmecanicainvasiva AT tocalinipablo influenciadelahipertensionintraabdominalenlamecanicarespiratoriadepacientesadultoscriticamenteenfermosconventilacionmecanicainvasiva AT novomarianoel influenciadelahipertensionintraabdominalenlamecanicarespiratoriadepacientesadultoscriticamenteenfermosconventilacionmecanicainvasiva AT vicenteantonela influenciadahipertensaointraabdominalnamecanicarespiratoriadepacientesadultosgravementeenfermoscomventilacaomecanicainvasiva AT virgiliosachaalexis influenciadahipertensaointraabdominalnamecanicarespiratoriadepacientesadultosgravementeenfermoscomventilacaomecanicainvasiva AT tocalinipablo influenciadahipertensaointraabdominalnamecanicarespiratoriadepacientesadultosgravementeenfermoscomventilacaomecanicainvasiva AT novomarianoel influenciadahipertensaointraabdominalnamecanicarespiratoriadepacientesadultosgravementeenfermoscomventilacaomecanicainvasiva |
| first_indexed |
2024-09-03T21:01:52Z |
| last_indexed |
2024-09-03T21:01:52Z |
| _version_ |
1809210212622532608 |
| spelling |
I10-R327-article-281482024-08-27T18:28:02Z Influence of intra-abdominal hypertension on the respiratory mechanics of critically ill adult patients with invasive mechanical ventilation Influencia de la hipertensión intraabdominal en la mecánica respiratoria de pacientes adultos críticamente enfermos con ventilación mecánica invasiva Influência da hipertensão intra-abdominal na mecânica respiratória de pacientes adultos gravemente enfermos com ventilação mecânica invasiva Vicente, Antonela Virgilio, Sacha Alexis Tocalini, Pablo Novo, María Noel intra-abdominal hypertension respiration, artificial respiratory mechanics intensive care units hipertensión intra-abdominal respiración artificial mecánica respiratoria unidades de cuidados intensivos hipertensão intra-abdominal respiração artificial mecânica respiratória unidades de terapia intensiva Objective: to describe the modifications in respiratory mechanics, the proposed ventilatory strategies and the correct positioning of critically ill adult patients with HIA and ACS with the requirement of IMV in the ICU. Data sources: the bibliographic search was carried out in Pubmed, Cochrane Library and Google Scholar® without restriction of the language with publication date until July 31, 2019. Study selection: adult patients with a requirement for IMV and diagnosis of HIA and / or ACS who have performed the ventilatory monitoring and patient positioning analysis. Laboratory studies on animals will be excluded. Data extraction: the initial search identified 681 studies, of which 30 articles were included for data analysis. Synthesis of data: patients with VMI requirement should be allowed to increase airway pressures and use of high PEEP; Only in specific cases could recruitment and prone maneuvering be applied to maintain adequate alveolar ventilation. Inverted Trendelemburg positioning is useful, as it improves respiratory mechanics and prevents abdominal compression. Conclusions: alterations in respiratory mechanics produce a decrease in thoracic compliance, lung volumes and oxygenation disorders. The ventilatory strategy should consider Vt between 6-8 ml / kg according to predicted body weight, working pressure less than 14 cm H2O, plateau pressure of 30 cm H2O + PIA / 2 and sufficient levels of PEEP to prevent lung collapse in order to expiration. Objetivo: describirlas modificaciones en la mecánica respiratoria, las estrategias ventilatorias propuestas y el correcto posicionamiento de los pacientes adultos críticamente enfermos con HIA y SCA con requerimiento de VMI en UCI. Fuentes de datos: la búsqueda bibliográfica fue realizada en Pubmed, Cochrane Library y Google Académico® sin restricción del lenguaje con fecha de publicación hasta el 31 de julio de 2019. Selección de los estudios: pacientes adultos con requerimiento de VMI y diagnóstico de HIA y/o SCA que hayan realizado el análisis de monitoreo ventilatorio y posicionamiento del paciente. Se excluirán los estudios de laboratorio realizados en animales. Extracción de datos: la búsqueda inicial identificó 681 estudios, de los cuales se incluyeron 30 artículos para el análisis de datos. Síntesis de datos: los pacientes con requerimiento de VMI se debe permitir el aumento de las presiones en la vía aérea y utilización de PEEP elevada; sólo en casos específicos se podrían aplicar maniobras de reclutamiento y decúbito prono para mantener una ventilación alveolar adecuada. El posicionamiento en Trendelemburg invertido es de utilidad, ya que mejora la mecánica respiratoria y evita la compresión abdominal. Conclusiones: las alteraciones de la mecánica respiratoria producen una disminución de la compliance torácica, volúmenes pulmonares y trastornos en la oxigenación. La estrategia ventilatoria debe contemplar Vt entre 6-8 ml/kg según peso corporal predicho, presión de trabajo menor a 14 cm H2O, presión meseta de 30 cm H2O+PIA/2 y niveles suficientes de PEEP para prevenir el colapso pulmonar a fin de espiración. Objetivo: descrever as modificações na mecânica respiratória, as estratégias ventilatórias propostas e o posicionamento correto de pacientes adultos críticos com AIH e SCA com necessidade de VMI na UTI. Fontes de dados: a pesquisa bibliográfica foi realizada na Pubmed, Cochrane Library e Google Scholar® sem restrição de idioma com data de publicação até 31 de julho de 2019. Seleção do estudo: pacientes adultos com necessidade de VMI e diagnóstico de HIA e / ou SCA que realizaram a monitoração ventilatória e análise de posicionamento do paciente. Estudos de laboratório em animais serão excluídos. Extração de dados: a busca inicial identificou 681 estudos, dos quais 30 artigos foram incluídos para análise dos dados. Síntese dos dados: os pacientes com necessidade de VMI devem ter permissão para aumentar a pressão nas vias aéreas e o uso de PEEP alto; Somente em casos específicos, o recrutamento e as manobras propensas podem ser aplicados para manter ventilação alveolar adequada. O posicionamento invertido de Trendelemburg é útil, pois melhora a mecânica respiratória e evita a compressão abdominal. Conclusões: alterações na mecânica respiratória produzem diminuição da complacência torácica, volumes pulmonares e distúrbios da oxigenação. A estratégia ventilatória deve considerar Vt entre 6-8 ml / kg de acordo com o peso corporal previsto, pressão de trabalho menor que 14 cm H2O, pressão de platô de 30 cm H2O + PIA / 2 e níveis suficientes de PEEP para evitar colapso pulmonar, a fim de expiração. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2020-12-01 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf text/html https://revistas.unc.edu.ar/index.php/med/article/view/28148 10.31053/1853.0605.v77.n4.28148 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 77 No. 4 (2020); 339-344 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 77 Núm. 4 (2020); 339-344 Revista da Faculdade de Ciências Médicas de Córdoba; v. 77 n. 4 (2020); 339-344 1853-0605 0014-6722 10.31053/1853.0605.v77.n4 spa https://revistas.unc.edu.ar/index.php/med/article/view/28148/32232 https://revistas.unc.edu.ar/index.php/med/article/view/28148/32495 Derechos de autor 2020 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0 |