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Impact of two extubation techniques on the intra-abdominal pressure: a preliminary study

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Abstract

Purpose

High pressure peaks might be a risk factor for the development of abdominal hernia. The course of abdominal pressure during extubation remains unclear. This preliminary study assessed the impact of two established extubation techniques.

Methods

Twenty-four consecutive patients suffering from abdominal wall hernia with the indication for surgical treatment were included. Twelve patients were extubated directly after the intravenous anaesthesia was stopped, before they had spontaneous breathing (deep extubation). The other 12 were extubated after they had spontaneous breathing (awake extubation). Intra-abdominal pressure (IAP) was measured via bladder catheter continuously.

Results

The highest value during extubation as well as the main increase in IAP was significantly lower in patients who underwent deep extubation (p < 0.001).

Conclusions

Therefore, this extubation technique might improve the outcome of hernia repair.

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References

  1. Cheatham ML et al (2004) Long-term physical, mental, and functional consequences of abdominal decompression. J Trauma 56(2):237–241 (discussion 241–2)

    Article  PubMed  Google Scholar 

  2. Smith C, Cheatham ML (2011) Intra-abdominal hypertension and abdominal compartment syndrome in the medical patient. Am Surg 77(Suppl 1):S67–S71

    PubMed  Google Scholar 

  3. Schein M et al (1995) The abdominal compartment syndrome: the physiological and clinical consequences of elevated intra-abdominal pressure. J Am Coll Surg 180(6):745–753

    CAS  PubMed  Google Scholar 

  4. Sanchez NC et al (2001) What is normal intra-abdominal pressure? Am Surg 67(3):243–248

    CAS  PubMed  Google Scholar 

  5. Cobb WS et al (2005) Normal intraabdominal pressure in healthy adults. J Surg Res 129(2):231–235

    Article  PubMed  Google Scholar 

  6. Iqbal A et al (2008) A study of intragastric and intravesicular pressure changes during rest, coughing, weight lifting, retching, and vomiting. Surg Endosc 22(12):2571–2575

    Article  PubMed  Google Scholar 

  7. Iqbal A et al (2006) Assessment of diaphragmatic stressors as risk factors for symptomatic failure of laparoscopic nissen fundoplication. J Gastrointest Surg 10(1):12–21

    Article  PubMed  Google Scholar 

  8. Fusco MA, Martin RS, Chang MC (2001) Estimation of intra-abdominal pressure by bladder pressure measurement: validity and methodology. J Trauma 50(2):297–302

    Article  CAS  PubMed  Google Scholar 

  9. De Keulenaer BL, Regli A, Malbrain ML (2011) Intra-abdominal measurement techniques: is there anything new? Am Surg 77(Suppl 1):S17–S22

    PubMed  Google Scholar 

  10. Malbrain ML (2004) Different techniques to measure intra-abdominal pressure (IAP): time for a critical re-appraisal. Intensive Care Med 30(3):357–371

    Article  PubMed  Google Scholar 

  11. Cannon DJ, Casteel L, Read RC (1984) Abdominal aortic aneurysm, Leriche’s syndrome, inguinal herniation, and smoking. Arch Surg 119(4):387–389

    Article  CAS  PubMed  Google Scholar 

  12. Cannon DJ, Read RC (1981) Metastatic emphysema: a mechanism for acquiring inguinal herniation. Ann Surg 194(3):270–278

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Jorgensen LN et al (1998) Less collagen production in smokers. Surgery 123(4):450–455

    Article  CAS  PubMed  Google Scholar 

  14. Abramson JH et al (1978) The epidemiology of inguinal hernia. A survey in western Jerusalem. J Epidemiol Community Health 32(1):59–67

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Rutkow IM (1998) Epidemiologic, economic, and sociologic aspects of hernia surgery in the United States in the 1990s. Surg Clin North Am 78(6):941–951 (pp v–vi)

    Article  CAS  PubMed  Google Scholar 

  16. Lau B et al (2012) Obesity increases the odds of acquiring and incarcerating noninguinal abdominal wall hernias. Am Surg 78(10):1118–1121

    PubMed  Google Scholar 

  17. Le Huu Nho R et al (2012) Incidence and prevention of ventral incisional hernia. J Visc Surg 149(5 Suppl):e3–e14

    Article  PubMed  Google Scholar 

  18. Sugerman H et al (1997) Intra-abdominal pressure, sagittal abdominal diameter and obesity comorbidity. J Intern Med 241(1):71–79

    Article  CAS  PubMed  Google Scholar 

  19. Ejike JC, Bahjri K, Mathur M (2008) What is the normal intra-abdominal pressure in critically ill children and how should we measure it? Crit Care Med 36(7):2157–2162

    Article  PubMed  Google Scholar 

  20. Basterra Longás A, Arizcun González S, Erdozain Ríos B (2008) Abviser Kit intra-abdominal pressure monitoring. Revista de enfermería 31(10):43–44

    PubMed  Google Scholar 

  21. Gudmundsson FF et al (2002) Comparison of different methods for measuring intra-abdominal pressure. Intensive Care Med 28(4):509–514

    Article  CAS  PubMed  Google Scholar 

  22. Yol S et al (1998) Is urinary bladder pressure a sensitive indicator of intra-abdominal pressure? Endoscopy 30(9):778–780

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

The authors RN, EN, CG, TW, FR and CH declare no conflict of interest.

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Correspondence to R. Nemecek.

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Nemecek, R., Nemecek, E., Glaser, C. et al. Impact of two extubation techniques on the intra-abdominal pressure: a preliminary study. Hernia 19, 307–311 (2015). https://doi.org/10.1007/s10029-014-1230-z

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  • DOI: https://doi.org/10.1007/s10029-014-1230-z

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