Ventilation in patients with intra-abdominal hypertension

Adrian Regli

doi:10.26182/w585-we75

Ventilation in patients with intra-abdominal hypertension

Adrian Regli

Internal Medicine

Research output: Thesis › Doctoral Thesis

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Abstract

The optimum modality of mechanical ventilation in patients with intra-abdominal hypertension (IAH) remains unknown. In basic preclinical and translational-clinical studies, we show a clear association between IAH and hypoxic respiratory failure with poor short-term outcomes. Additional intra-abdominal volume exponentially increases inspiratory airway pressures. Positive end-expiratory pressure (PEEP) in the presence of IAH improves oxygenation and decreases atelectasis at the cost of overdistended lung and reduced cardiac function. Relative to moderate PEEP, high PEEP is tolerated poorly by patients with IAH. However, an optimal PEEP that predominantly improves oxygenation and prevents atelectasis without causing overdistension or hemodynamic compromise was not found.

Original language	English
Qualification	Doctor of Philosophy
Awarding Institution	The University of Western Australia
Supervisors/Advisors	Pillow, Jane, Supervisor van Heerden, Vernon, Supervisor Davis, Wendy, Supervisor
Thesis sponsors	Australian Government Research Training Program
Award date	16 Aug 2021
DOIs	https://doi.org/10.26182/w585-we75
Publication status	Unpublished - 2021

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Embargoed from 06/09/2021 to 23/11/2021. Made publicly available on 23/11/2021.

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10.26182/w585-we75

THESIS - DOCTOR OF PHILOSOPHY - REGLI, Adrian - 2021
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Cite this

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title = "Ventilation in patients with intra-abdominal hypertension",

abstract = "The optimum modality of mechanical ventilation in patients with intra-abdominal hypertension (IAH) remains unknown. In basic preclinical and translational-clinical studies, we show a clear association between IAH and hypoxic respiratory failure with poor short-term outcomes. Additional intra-abdominal volume exponentially increases inspiratory airway pressures. Positive end-expiratory pressure (PEEP) in the presence of IAH improves oxygenation and decreases atelectasis at the cost of overdistended lung and reduced cardiac function. Relative to moderate PEEP, high PEEP is tolerated poorly by patients with IAH. However, an optimal PEEP that predominantly improves oxygenation and prevents atelectasis without causing overdistension or hemodynamic compromise was not found.",

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AB - The optimum modality of mechanical ventilation in patients with intra-abdominal hypertension (IAH) remains unknown. In basic preclinical and translational-clinical studies, we show a clear association between IAH and hypoxic respiratory failure with poor short-term outcomes. Additional intra-abdominal volume exponentially increases inspiratory airway pressures. Positive end-expiratory pressure (PEEP) in the presence of IAH improves oxygenation and decreases atelectasis at the cost of overdistended lung and reduced cardiac function. Relative to moderate PEEP, high PEEP is tolerated poorly by patients with IAH. However, an optimal PEEP that predominantly improves oxygenation and prevents atelectasis without causing overdistension or hemodynamic compromise was not found.

KW - Intra-abdominal hypertension

KW - Mechanical ventilation

KW - Positive end-expiratory pressure

KW - Intensive care

KW - Airway pressures

KW - Alveolar distension

KW - Lung atelectasis

KW - Cardiac function

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M3 - Doctoral Thesis

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Ventilation in patients with intra-abdominal hypertension

Abstract

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