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Effects of positive end-expiratory pressure on respiratory function and hemodynamics in patients with acute respiratory failure with and without intra-abdominal hypertension a pilot study.doc

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Effects of positive end-expiratory pressure on respiratory function and hemodynamics in patients with acute respiratory failure with and without intra-abdominal hypertension a pilot study

Available online /content/13/5/R160 Research Open Access Vol 13 No 5 Effects of positive end-expiratory pressure on respiratory function and hemodynamics in patients with acute respiratory failure with and without intra-abdominal hypertension: a pilot study Joerg Krebs1, Paolo Pelosi2, Charalambos Tsagogiorgas1, Markus Alb1 and Thomas Luecke1 1Department of Anesthesiology and Critical Care Medicine, University Hospital Mannheim, Faculty of Medicine, University of Heidelberg, Mannheim, Germany, Theodor-Kutzer Ufer, Mannheim, 68165, Germany 2Department of Ambient, Health and Safety, University of Insubria, c/o Villa Toeplitz Via G.B. Vico, 46 Varese, 21100, Italy Corresponding author: Thomas Luecke, thomas.luecke@anaes.ma.uni-heidelberg.de Received: 5 Aug 2009 Revisions requested: 16 Sep 2009 Revisions received: 19 Sep 2009 Accepted: 5 Oct 2009 Published: 5 Oct 2009 Critical Care 2009, 13:R160 (doi:10.1186/cc8118) This article is online at: /content/13/5/R160 ? 2009 Krebs et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction To investigate the effects of positive end- hemodynamics, extravascular lung water index (EVLWI) and intrathoracic blood volume index (ITBVI). expiratory pressure (PEEP) on respiratory function and hemodynamics in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) with normal intra- abdominal pressure (IAP 12 mmHg) and with intra-abdominal hypertension (IAH, defined as IAP ≥ 12 mmHg) during lung protective ventilation and a decremental PEEP, a prospective, observational clinical pilot study was performed. Results We found that ALI/ARDS patients with IAH, as compared to those with normal IAP, w