A proposed relationship between increased intra-abdominal, intrathoracic, and intracranial pressure

Bloomfield, Geoffrey L.; Ridings, Philip C.; Blocher, Charles R.; Marmarou, Anthony; Sugerman, Harvey J.

doi:10.1097/00003246-199703000-00020

Cited by 353 publications

(175 citation statements)

References 32 publications

Supporting

Mentioning

144

Contrasting

Unclassified

Order By: Relevance

“…Morbidly obese patients have signi®cantly higher intraabdominal pressures than nonobese patients, and have a higher incidence of IIH. 20 These authors evaluated the relationship between increased intraabdominal pressures, intracranial pressure and cerebral perfusion pressure 21 and in a later study 20 suggested that increased intraabdominal pressure produced raised intracranial pressure by raising the diaphragm and increasing intrathoracic pressure, thereby reducing cerebral venous return to the heart via the jugular vein system. This in turn would obstruct cerebral venous out¯ow, raise cerebral blood volume and increase intracranial pressure by preventing normal cerebrospinal¯uid absorption.…”

Section: Pathophysiologymentioning

confidence: 99%

The relationship between obesity and idiopathic intracranial hypertension

Rowe

1999

Int J Obes

View full text Add to dashboard Cite

OBJECTIVES: To evaluate the association between obesity and idiopathic intracranial hypertension (IIH) and establish whether there is a relationship with visual outcome. To calculate the prevalence and degree of obesity in a group of patients with IIH. METHODS: 34 patients (31 female and 3 male) were recruited between 1993 ± 1997 with a diagnosis of IIH. Assessment included visual acuity, visual ®eld assessment (Humphrey automated and Goldmann manual perimetry), fundus assessment and measurement of body mass index (BMI). Obesity was de®ned as a BMI of 30 kgam 2 . RESULTS: 70.5% of patients were obese. The relative risk for obesity and IIH was signi®cant at 8 (95%CI: 2,29). This increased to 17 (95%CI: 5,62) for obese females aged 16 to 24 years and 10 (95%CI: 3,35.5) for obese females aged 25 to 34 years. Morbid obesity (BMI b 40) was signi®cantly associated with poor visual outcome. Serial obesity measures showed generally little change in weight over time and there was no correlation between weight change and visual improvement. CONCLUSIONS: This study has documented a relationship between obesity and IIH. A high degree of obesity was associated with a poor visual function and identi®ed as a risk factor for poor outcome. Obesity may be an aetiological factor in this condition although it is unlikely to be the sole cause but more probably a precipitating factor. Weight loss is recommended although failure to lose weight is common. Any weight reduction programme must therefore be actively encouraged and monitored.

show abstract

Section: Pathophysiologymentioning

confidence: 99%

The relationship between obesity and idiopathic intracranial hypertension

Rowe

1999

Int J Obes

View full text Add to dashboard Cite

show abstract

“…The elevated intra-abdominal pressure is a function of the rate of fluid accumulation within the abdominal cavity and the compliance of the abdomen [2]. Elevation in intracranial pressure and depression of cerebral perfusion pressure may also result from increased intra-abdominal pressure [3]. In our patient, the abdominal distension from the irrigating fluid resulted in hypotension.…”

Section: Discussionmentioning

confidence: 62%

Abdominal compartment syndrome during hip arthroscopy

2009

View full text Add to dashboard Cite

show abstract

“…A aplicação das manobras cinéticas de fisioterapia respiratória promove aumento momentâneo da pressão intratorácica, diminuindo o retorno venoso cerebral e elevando a PIC nesses p acientes [3][4][5][6] .…”

Section: Abstract -O B J E C T I V Eunclassified

Influência da fisioterapia respiratória na pressão intracraniana em pacientes com traumatismo craniencefálico grave

Thiesen

Dragosavac

Roquejani

et al. 2005

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

RESUMO -O b j e t i v o:Estudar a influência das manobras de fisioterapia respiratória na pressão intracraniana (PIC) dos pacientes com trauma craniencefálico grave. Método: Trinta e cinco pacientes com trauma craniencefálico grave foram incluídos no estudo, sendo divididos em três grupos: com PIC < 10, 11-20 e 21-30 mmHg. As variáveis monitorizadas foram: PIC e pressão arterial média. A pressão de perfusão cerebral foi calculada pela diferença de pressão arterial média e PIC. Resultados: A manobra de aspiração traqueal causou aumento de PIC em todos os grupos. A pressão arterial média não teve alterações e a pressão de perfusão cerebral diminuiu pouco, porém mantendo valores normais. Conclusão: As manobras de fisioterapia respiratória podem ser usadas com segurança em pacientes com traumatismo craniencefálico grave, com PIC abaixo de 30 mmHg.Certo cuidado deve ser tomado durante a aspiração traqueal.PALAVRAS-CHAVE: traumatismo craniencefálico, fisioterapia respiratória, pressão intracraniana, pressão de perfusão cerebral.Influence of the respiratory physioterapy on intracranial pre s s u re in severe head trauma patients ABSTRACT -O b j e c t i v e:To evaluate influence of the respiratory physiotherapy on intracranial pressure (ICP) in patients with severe head trauma. M e t h o d: Thirty five patients with severe head trauma were included in the study.The patients were divided into three groups: ICP 0-10, 11-20 and 21-30 mmHg. The following variables were measured: ICP and mean arterial pressure. Cerebral perfusion pressure was calculated as the difference between mean arterial and intracranial pressure. R e s u l t s: Endotracheal aspiration increased ICP in all patients. The mean arterial pressure didn't change and cerebral perfusion pressure decreased, but remaning normal value. Conclusion: Respiratory physiotherapy maneuvers can be safely applied in patients with severe head trauma with ICP below 30 mmHg. More attention should be taken during endotracheal aspiration .KEY WORDS: head injury, respiratory physioterapy, intracranial pressure, cerebral perfusion pressure.Os pacientes com traumatismo craniencefálico (TCE) grave, com escala de coma de Glasgow igual ou menor que 8, são geralmente submetidos à monitorização da pressão intracraniana (PIC), e da pressão arterial média (PAM) e tratados de acordo c o m um protocolo rígido de assistência, que inclui sedação, elevação de cabeceira do leito, ventilação mecânica otimizada, fisioterapia respiratória e motora, entre outras 1 , 2 . A aplicação das manobras cinéticas de fisioterapia respiratória promove aumento momentâneo da pressão intratorácica, diminuindo o retorno venoso cerebral e elevando a PIC nesses p acientes [3][4][5][6] .Sabe-se que as alterações da PIC influenciam diretamente a pressão de perfusão cerebral (PPC), que é calculada como diferença entre a PAM e a PIC. Portanto, aumentos da PIC poderiam acarretar diminuição da PPC, se não houver aumento conco-

show abstract

A proposed relationship between increased intra-abdominal, intrathoracic, and intracranial pressure

Cited by 353 publications

References 32 publications

The relationship between obesity and idiopathic intracranial hypertension

The relationship between obesity and idiopathic intracranial hypertension

Abdominal compartment syndrome during hip arthroscopy

Influência da fisioterapia respiratória na pressão intracraniana em pacientes com traumatismo craniencefálico grave

Contact Info

Product

Resources

About