Modeling intra-abdominal volume and respiratory driving pressure during pneumoperitoneum insufflation—a patient-level data meta-analysis

Author:

Mazzinari Guido12ORCID,Diaz-Cambronero Oscar123,Serpa Neto Ary456,Martínez Antonio Cañada7,Rovira Lucas8,Argente Navarro María Pilar12,Malbrain Manu L.N.G91011,Pelosi Paolo1213,Gama de Abreu Marcelo1415,Hollmann Markus W.416,Schultz Marcus J.41718

Affiliation:

1. Research Group in Perioperative Medicine, Hospital Universitario y Politécnico la Fe, Valencia, Spain

2. Department of Anaesthesiology, Hospital Universitario y Politécnico la Fe, Valencia, Spain

3. Spanish Clinical Research Network (SCReN), SCReN-IIS La Fe, Madrid, Spain

4. Department of Intensive Care & Laboratory of Experimental Intensive Care and Anesthesiology (LEICA), Amsterdam University Medical Center, location “AMC.” Amsterdam, The Netherlands

5. Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil

6. Pulmonary Division, Cardio-Pulmonary Department, Instituto do Coração, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil

7. Data Science, Biostatistics and Bioinformatics Unit, Instituto de Investigacion Sanitaria la Fe, Valencia, Spain

8. Department of Anaesthesiology, Consorcio Hospital General Universitario, Valencia, Spain

9. Department of Intensive Care Medicine, University Hospital Brussels (UZB), Brussels, Belgium

10. Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium

11. International Fluid Academy, Lovenjoel, Belgium

12. San Martino Policlinico Hospital—IRCCS for Oncology and Neurosciences, Genoa, Italy

13. Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy

14. Department of Anesthesiology and Intensive Care Therapy, Pulmonary Engineering Group, Technische Universität Dresden, Dresden, Germany

15. Outcomes Research Consortium, Cleveland, Ohio

16. Department of Anaesthesiology, Amsterdam University Medical Center, location “AMC,” Amsterdam, The Netherlands

17. Mahidol Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand.

18. Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom

Abstract

We found that intra-abdominal volume changes related to intra-abdominal pressure increase reached a plateau with diminishing gains in commonly used pneumoperitoneum pressure ranges. We also found a linear relationship between intra-abdominal pressure and respiratory driving pressure, a known marker of postoperative pulmonary complications.

Funder

Merck Sharp and Dohme

Publisher

American Physiological Society

Subject

Physiology (medical),Physiology

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