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

Abstract

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 (0 • , 15• , and 30 • ). 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 0 • , 15• , and 30• respectively. The mean of IAP difference was 3.7 ± 3.0 mmHg at 0 • , 3.8 ± 1.00 mmHg at 15• , and 5.5 ± 1.01 mmHg at 30 • (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

What is the Relationship among Patients' Position and Intra-abdominal Pressure and Mean Arterial Pressure?

“…In this regard, non-randomized, prospective study of Mahran et al, to investigate the effect of lateral position on intra-abdominal pressure compared to supine position in patients undergoing mechanical ventilation. This study showed that when the patient's body position changes from supine to lateral, the mean intraabdominal pressure increases [26], which was consistent with the results of our study.…”