Open Access Peer-reviewed

Intra-abdominal Pressure is Influenced by Body Position?

António M. Lopes1, 2,, Andreia Nunes2, Maria M. R. E. Niza3, António Dourado1

1University of Coimbra – Department of Informatics Engineering, Center for Informatics and Systems of the University of Coimbra (CISUC), Polo II University of Coimbra, 3030-290 Coimbra, Portugal

2University Lusofona – Faculty of Veterinary Medicine, Avenida do Campo Grande, 3761749-024 Lisboa, Portugal

3University of Lisbon - Faculty of Veterinary Medicine, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal

American Journal of Clinical Medicine Research. 2016, 4(1), 11-18. DOI: 10.12691/ajcmr-4-1-3
Published online: August 25, 2017

Abstract

Background: Increased intra-abdominal pressure (IAP) is a complication related to physio pathological changes with high rates of mortality and morbidity. Abdominal surgery is consider one of the risk factors that can increased IAP. Measurement can be done by direct or indirect methods, being the most used the transurethral (TM). However this method continues to generate some controversy. This study tries to clarify the doubts of the effect of body position when we use different methods to measure IAP. Methodology: Study realized an anatomical model in order to eliminate the described variables that influence IAP: abdominal and gastric contraction, micturition reflex and breathing. IAP was measured, directly, via microsensor and, indirectly, by TM and intragastric manometry, in five different body positions. The study population consists in a population of 29 anatomical model, 14 males and 15 females, with an average weight of 12.04 ± 5.67 kilograms (Kg). The inclusion criteria consisted in the absence of abdominal disease that would. Principal Findings: IAP determination by direct method showed no differences in the five body positions (P=0.765). The indirect method with better correlation with the direct was TM (cc0.87). Indirect methods revealed statistically significant differences with the direct, only in the Trendelenburg and reverse Trendelenburg. Conclusions: The clinical impact of this study is to decrease the doubts in the measurements of IAP. This study improves the knowledge of the application of the direct and indirect methods to accesses IAP. IAP is not affected by body position and the direct pressure value measured in all positions is constant. Only if the indirect methods are used, in Trendelenburg and reverse Trendelenburg positions, they may underestimate or overestimate IAP value. For the first time it was explained why this phenomenon occurs.

Keywords:

Abdominal surgery, Intra-abdominal pressure, transurethral method, intragastric manometry, body position
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