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| 1 | Effect of intra-abdominal pressure on respiratory function in patients undergoing ventral hernia repair显示文摘AIM: To determine the influence of intra-abdominal pressure(IAP) on respiratory function after surgical repair of ventral hernia and to compare two different methods of IAP measurement during the perioperative period. METHODS: Thirty adult patients after elective repair of ventral hernia were enrolled into this prospective study.IAP monitoring was performed via both a balloontipped nasogastric probe [intragastric pressure(IGP), Ci MON, Pulsion Medical Systems, Munich, Germany] and a urinary catheter [intrabladder pressure(IBP), Uno Meter Abdo-Pressure Kit, Uno Medical, Denmark] on five consecutive stages:(1) after tracheal intubation(AI);(2) after ventral hernia repair;(3) at the end of surgery;(4) during spontaneous breathing trial through the endotracheal tube; and(5) at 1 h after tracheal extubation. The patients were in the complete supine position during all study stages.RESULTS: The IAP(measured via both techniques) increased on average by 12% during surgery compared to AI(P < 0.02) and by 43% during spontaneous breathing through the endotracheal tube(P < 0.01). In parallel, the gradient between РаСО2 and Et CO2 [Р(а-et)CO2] rose significantly, reaching a maximum during the spontaneous breathing trial. The PаO2/Fi O2 decreased by 30% one hour after tracheal extubation(P = 0.02). The dynamic compliance of respiratory system reduced intraoperatively by 15%-20%(P < 0.025). At all stages, we observed a significant correlation between IGP and IBP(r = 0.65-0.81, P < 0.01) with a mean bias varying from-0.19 mm Hg(2SD 7.25 mm Hg) to-1.06 mm Hg(2SD 8.04 mm Hg) depending on the study stage. Taking all paired measurements together(n = 133), the median IGP was 8.0(5.5-11.0) mm Hg and the median IBP was 8.8(5.8-13.1) mm Hg. The overall r2 value( n = 30) was 0.76(P < 0.0001). Bland and Altman analysis showed an overall bias for the mean values per patient of 0.6 mm Hg(2SD 4.2 mm Hg) with percentage error of 45.6%. Looking at changes in IAP between the different study stages, we found an excellent concordance coefficient of 94.9% comparing IBP and IGP( n = 117).CONCLUSION: During ventral hernia repair, the IAP rise is accompanied by changes in Р(а-et)CO2 and PаO2/Fi O2-ratio. Estimation of IAP via IGP or IBP demonstrated excellent concordance. | Konstantin M Gaidukov Elena N Raibuzhis Ayyaz Hussain Alexey Y Teterin Alexey A Smetkin Vsevolod V Kuzkov Manu LNG Malbrain Mikhail Y Kirov | 2013 | World Journal of Critical Care Medicine2013，2，2： | 2 |
| 2 | Recombinant humanactivated protein C ameliorates oleic acid -induced lung injury in a-wake sheep显示文摘 | Waerhaug K Kirov M Y Kuzkov V V | 2008 | Crit Care2008，12，6： | 1 |
| 3 | Perioperative haemodynamic therapy 显示文摘 | Kirov MY Kuzkov VV Molnar Z | 2010 | Curr Opin Crit Care2010，16，4： | 1 |
| 4 | Inhaled aero solised recombinant human activated protein C amelio- rates endotoxin-induced lung injury in anaesthetised sheep 显示文摘 | Waerhaug K Kuzkov VV Kuklin VN | 2009 | Crit Care2009，13，2： | 1 |
| 5 | Extravascular lung water determined with single transpulmonary thermodilution correlates with the severity of sepsis-induced acute lung injury显示文摘 | Kuzkov VV Kirov MY Sovershaev MA | 2006 | Crit Care Med2006，34，6： | 1 |
| 6 | Extravacular lung water determined with single transpulmonary thermedilution correlates with the severity of sepsis-induced acute lung injury显示文摘 | Kuzkov W Kirov MY Soversllaev MA | 2006 | Crit Care Med2006，34，6： | 1 |
| 7 | Extravascular lung water assessed by transpuhnonary single thermodilution and postmortem gravimetry in sheep 显示文摘 | Kirov MY Kuzkov W Kuklin VN | 2004 | Crit Care2004，8，6： | 1 |
| 8 | Recombinant human activated protein C ameliorates oleic acid-induced lung injury in awake sheep显示文摘 | Waerhaug K Kirov MY Kuzkov VV | 2008 | Crit Care2008，12，6： | 1 |
| 9 | Extravascular lung water determined with single transpulmonary thermodilution correlates with the severity of sepsis-induced acute lung injury显示文摘 | Kuzkov VV Kirov MY Sovershaev MA | | 0，，6： | 1 |
| 10 | Comparison of goal - directed hemodynamic optimization using pulmonary artery catheter and transpulmonary thermodilution in combined valve repair: a randomized clinical trial显示文摘 | Lenkin AI Kirov MY Kuzkov VV | 2012 | Crit Care Res Pract2012，2012，82： | 1 |
| 11 | Extravaular lung water determined with single transpulmonary thermedilution eorrelal with theseverity of sepsis-induced acute lung inury 显示文摘 | Kuzkov W Kirov MY Soversllaev MA | 2006 | Crit Care Med2006，34，6： | 1 |
| 12 | Extravoscular lung water assessed by transpulmonary single thermodilution and postmortem gravimetry in sheep显示文摘 | Kirov MY Kuzkov W Kuklin VN | 2004 | Crit Care2004，8，6： | 1 |
| 13 | Single transpulmonary thermodilution in off-pump coronary artery bypass grafting:haemodynamic changes and effects of different anaesthetic techniques显示文摘 | Kirov MY Lenkin AI Kuzkov VV | 2007 | J Acta Anaesthesiol Scand2007，51，4： | 1 |
| 14 | Extravascularlung water determined with single transpulmonary thermodilutioncorrelates with the severity of sepsis-induced acute lung injury 显示文摘 | Kuzkov VV Kirov MY Sovershaev MA | 2006 | Crit Care Med2006，34，6： | 1 |
| 15 | Extravascular lung water determined with single transpulmonary thermodilution correlates with the severity of sepsis-induced acute lung injury显示文摘 | Kuzkov VV Kirov MY Sovershaev MA | | 0，，6： | 1 |
| 16 | Extravascular lung water assessed by transpulmonary single thermodilution and postmortem gravimetry in sheep显示文摘 | Kirov M Y Kuzkov V V Kuklin V N | 2004 | Crit Care2004，8，： | 1 |
| 17 | Extravascular lung water determined with single tanspulmonary thermodilution correlates with the severity of sepsis-induced acute lung injury显示文摘 | Kuzkov VV Kirov MY Sovershaev MA | 2006 | Crit Care Med2006，34，6： | 1 |
| 18 | Extravascular lung water determined with single transpulmonary thermodilution correlates with the severity of sepsis - induced acute lung injury 显示文摘 | Kuzkov VV Kirov MY Sovershaev MA | 2006 | Crit Care Med2006，34，6： | 1 |
| 19 | Extravascular lung water assessed by transpulmonary single thermodilution and postmortem gravimetry in sheep显示文摘 | Kirov MY Kuzkov VV Kuklin VN | 2004 | Crit Care2004，8，6： | 1 |
| 20 | Extravasculalung water determined with single transpulmonary thermodilution correlates with the severity of sepsis induced acute lung injury显示文摘 | Kuzkov VV Kirov MY Sovershaev MA | 2006 | Crit Care Med2006，34，6： | 1 |
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