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经导尿管和鼻胃管比较不同体位下的腹腔内压力：一项初步研究。

Comparing intra-abdominal pressures in different body positions via a urinary catheter and nasogastric tube: a pilot study.

机构信息

Intensive Care Unit, Fremantle Hospital, 1 Alma Street, 6160 Fremantle, Western Australia, Australia.

出版信息

Ann Intensive Care. 2012 Jul 5;2 Suppl 1(Suppl 1):S11. doi: 10.1186/2110-5820-2-S1-S11.

DOI:10.1186/2110-5820-2-S1-S11
PMID:22873412
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3390294/
Abstract

OBJECTIVES

Intra-abdominal pressure (IAP) is most commonly measured via the bladder with the patient in the supine position. In the ICU, patients are nursed with the head of the bed elevated at 30° (HOB30) to reduce the risk of ventilator-associated pneumonia. This study investigated whether gastric pressure at HOB30 can be used as a surrogate measure of IAP via the bladder in the supine position.

METHODS

A prospective observational study was conducted in a single-centre intensive care unit. A total of 20 patients were included. IAP was recorded simultaneously via the bladder catheter (bladder pressure, IBP) and via nasogastric tube (gastric pressures, IGP) in the supine and HOB30 position. Each patient had three sets of IAP measurements performed at least 4 h apart.

RESULTS

In the supine position, mean IBP was 12.3 ± 4.5 mmHg compared to IGP of 11.8 ± 4.7 mmHg. The bias between the two groups was 0.5 and precision of 3.7 (LA, -6.8 to 7.5 mmHg). At 30 degrees, mean IBP was 15.8 ± 4.9 mmHg compared to IGP of 13.1 ± 6.1 mmHg. The bias between both groups was 2.7 with a precision of 5.5 (LA, -8.0 to 13.5). Comparing IBP in the supine position with IGP at 30° showed a bias of -0.8 and precision of 5.6 (LA, -10.1 to 11.6 mmHg).

CONCLUSION

IAP measured via a nasogastric tube was less influenced by changing the body position from supine to HOB30 than was bladder pressure.

摘要

目的

腹腔内压（IAP）最常通过仰卧位患者的膀胱进行测量。在 ICU 中，患者床头抬高 30°（HOB30）以降低呼吸机相关性肺炎的风险。本研究旨在探讨仰卧位时 HOB30 胃内压是否可通过膀胱作为 IAP 的替代测量值。

方法

在单中心重症监护病房进行了一项前瞻性观察性研究。共纳入 20 例患者。同时通过膀胱导管（膀胱压，IBP）和通过鼻胃管（胃内压，IGP）在仰卧位和 HOB30 位记录 IAP。每位患者至少间隔 4 小时进行三组 IAP 测量。

结果

仰卧位时，平均 IBP 为 12.3±4.5mmHg，而 IGP 为 11.8±4.7mmHg。两组之间的偏差为 0.5mmHg，精度为 3.7mmHg（LA，-6.8 至 7.5mmHg）。30 度时，平均 IBP 为 15.8±4.9mmHg，而 IGP 为 13.1±6.1mmHg。两组之间的偏差为 2.7mmHg，精度为 5.5mmHg（LA，-8.0 至 13.5mmHg）。比较仰卧位时的 IBP 与 30°时的 IGP，偏差为-0.8mmHg，精度为 5.6mmHg（LA，-10.1 至 11.6mmHg）。

结论

与膀胱压相比，胃内压在从仰卧位变为 HOB30 时受体位变化的影响较小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b59e/3390294/2ea856bf1af1/2110-5820-2-S1-S11-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b59e/3390294/5959a993be12/2110-5820-2-S1-S11-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b59e/3390294/45cdec469411/2110-5820-2-S1-S11-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b59e/3390294/2ea856bf1af1/2110-5820-2-S1-S11-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b59e/3390294/5959a993be12/2110-5820-2-S1-S11-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b59e/3390294/45cdec469411/2110-5820-2-S1-S11-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b59e/3390294/2ea856bf1af1/2110-5820-2-S1-S11-3.jpg

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