Impact of large volume paracentesis on respiratory parameters including transpulmonary pressure and on transpulmonary thermodilution derived hemodynamics: A prospective study

Impact of large volume paracentesis on respiratory parameters including transpulmonary pressure and on transpulmonary thermodilution derived hemodynamics: A prospective study

Appropriate mechanical ventilation and prevention of alveolar collaps is mainly dependent on transpulmonary pressure TPP. TPP is assessed by measurement of esophageal pressure EP, largely influenced by pleural and intraabdominal pressure IAP. Consecutively, TPP-guided ventilation might be particular...

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Veröffentlicht in:PloS one 2018-03, Vol.13 (3), p.e0193654-e0193654
Hauptverfasser: Mayr, Ulrich, Karsten, Eugen, Lahmer, Tobias, Rasch, Sebastian, Thies, Philipp, Henschel, Benedikt, Fischer, Gerrit, Schmid, Roland M, Huber, Wolfgang
Format: Artikel
Sprache:eng
Schlagworte:
Abdomen
Alveoli
Ascites
Biology and Life Sciences
Blood pressure
Circulatory system
Cirrhosis
Digestive system surgery
Engineering and Technology
Esophagus
Gastroenterology
Health aspects
Heart diseases
Hemodynamics
Hypertension
Intensive care
Liver
Liver cirrhosis
Lungs
Mechanical ventilation
Medicine and Health Sciences
Methods
Oxygenation
Parameters
Patient outcomes
Patients
Respiration
Respiratory distress syndrome
Respiratory function
Respiratory rate
Respiratory system
Studies
Systematic review
Ventilation
Ventilators
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Zusammenfassung:Appropriate mechanical ventilation and prevention of alveolar collaps is mainly dependent on transpulmonary pressure TPP. TPP is assessed by measurement of esophageal pressure EP, largely influenced by pleural and intraabdominal pressure IAP. Consecutively, TPP-guided ventilation might be particularly useful in patients with high IAP. This study investigates the impact of large volume paracentesis LVP on TPP, EP, IAP as well as on hemodynamic and respiratory function in patients with liver cirrhosis and tense ascites. We analysed 23 LVP-procedures in 11 cirrhotic patients ventilated with the AVEA Viasys respirator (CareFusion, USA) which is capable to measure EP via an esophageal tube. LVP of a mean volume of 4826±1276 mL of ascites resulted in marked increases in inspiratory (17.9±8.9 vs. 5.4±13.3 cmH2O; p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0193654