AIM: To determine the influence of intra-abdominal pressure(IAP) on respiratory function after surgical repair of ventral hernia and to compare two different methods of IAP measurement during the perioperative period....AIM: To determine the influence of intra-abdominal pressure(IAP) on respiratory function after surgical repair of ventral hernia and to compare two different methods of IAP measurement during the perioperative period. METHODS: Thirty adult patients after elective repair of ventral hernia were enrolled into this prospective study.IAP monitoring was performed via both a balloontipped nasogastric probe [intragastric pressure(IGP), Ci MON, Pulsion Medical Systems, Munich, Germany] and a urinary catheter [intrabladder pressure(IBP), Uno Meter Abdo-Pressure Kit, Uno Medical, Denmark] on five consecutive stages:(1) after tracheal intubation(AI);(2) after ventral hernia repair;(3) at the end of surgery;(4) during spontaneous breathing trial through the endotracheal tube; and(5) at 1 h after tracheal extubation. The patients were in the complete supine position during all study stages.RESULTS: The IAP(measured via both techniques) increased on average by 12% during surgery compared to AI(P < 0.02) and by 43% during spontaneous breathing through the endotracheal tube(P < 0.01). In parallel, the gradient between РаСО2 and Et CO2 [Р(а-et)CO2] rose significantly, reaching a maximum during the spontaneous breathing trial. The PаO2/Fi O2 decreased by 30% one hour after tracheal extubation(P = 0.02). The dynamic compliance of respiratory system reduced intraoperatively by 15%-20%(P < 0.025). At all stages, we observed a significant correlation between IGP and IBP(r = 0.65-0.81, P < 0.01) with a mean bias varying from-0.19 mm Hg(2SD 7.25 mm Hg) to-1.06 mm Hg(2SD 8.04 mm Hg) depending on the study stage. Taking all paired measurements together(n = 133), the median IGP was 8.0(5.5-11.0) mm Hg and the median IBP was 8.8(5.8-13.1) mm Hg. The overall r2 value( n = 30) was 0.76(P < 0.0001). Bland and Altman analysis showed an overall bias for the mean values per patient of 0.6 mm Hg(2SD 4.2 mm Hg) with percentage error of 45.6%. Looking at changes in IAP between the different study stages, we found an excellent concordance coeff展开更多
Purpose of the present study: To explore the effect of electroacupuncture (EA) on canine pyloric pressure and its relation to somatostain (SS) of blood plasma and nitric oxide (NO).Methods: An intragastric pressure de...Purpose of the present study: To explore the effect of electroacupuncture (EA) on canine pyloric pressure and its relation to somatostain (SS) of blood plasma and nitric oxide (NO).Methods: An intragastric pressure detector and radioimmunoassay (RIA) and biochemical assay are used to determine changes of pyloric pressure and frequency, contents of SS and NO of blood plasma after EA stimulation of different acupoints. Results: Following EA of Zusanli (ST 36), the total pressure, basic pressure and systolic frequency of the sphincter muscle of pylorus lowered, plasma SS content decreased and NO content increased. After EA of Shangjuxu (ST 37), the total pressure, basic pressure and systolic frequency of the sphincter muscle of pylorus decreased, plasrna NO content increased but changes of these indexes are less obvious than those of EA of Zusanli (ST 36). These indexes in other groups had no any apparent changes. Conclusion: EA could lower pyloric pressure and systolic frequency of the pyloric sphincter muscle, whicb may be the important pathway of EA in regulating functional activities of the stomach and intestines. The effect of EA is associated with the contents of some plasma biological substances affecting pyloric pressure and the action of meridians and acupoints is of specificity to a certain degree.展开更多
文摘AIM: To determine the influence of intra-abdominal pressure(IAP) on respiratory function after surgical repair of ventral hernia and to compare two different methods of IAP measurement during the perioperative period. METHODS: Thirty adult patients after elective repair of ventral hernia were enrolled into this prospective study.IAP monitoring was performed via both a balloontipped nasogastric probe [intragastric pressure(IGP), Ci MON, Pulsion Medical Systems, Munich, Germany] and a urinary catheter [intrabladder pressure(IBP), Uno Meter Abdo-Pressure Kit, Uno Medical, Denmark] on five consecutive stages:(1) after tracheal intubation(AI);(2) after ventral hernia repair;(3) at the end of surgery;(4) during spontaneous breathing trial through the endotracheal tube; and(5) at 1 h after tracheal extubation. The patients were in the complete supine position during all study stages.RESULTS: The IAP(measured via both techniques) increased on average by 12% during surgery compared to AI(P < 0.02) and by 43% during spontaneous breathing through the endotracheal tube(P < 0.01). In parallel, the gradient between РаСО2 and Et CO2 [Р(а-et)CO2] rose significantly, reaching a maximum during the spontaneous breathing trial. The PаO2/Fi O2 decreased by 30% one hour after tracheal extubation(P = 0.02). The dynamic compliance of respiratory system reduced intraoperatively by 15%-20%(P < 0.025). At all stages, we observed a significant correlation between IGP and IBP(r = 0.65-0.81, P < 0.01) with a mean bias varying from-0.19 mm Hg(2SD 7.25 mm Hg) to-1.06 mm Hg(2SD 8.04 mm Hg) depending on the study stage. Taking all paired measurements together(n = 133), the median IGP was 8.0(5.5-11.0) mm Hg and the median IBP was 8.8(5.8-13.1) mm Hg. The overall r2 value( n = 30) was 0.76(P < 0.0001). Bland and Altman analysis showed an overall bias for the mean values per patient of 0.6 mm Hg(2SD 4.2 mm Hg) with percentage error of 45.6%. Looking at changes in IAP between the different study stages, we found an excellent concordance coeff
文摘Purpose of the present study: To explore the effect of electroacupuncture (EA) on canine pyloric pressure and its relation to somatostain (SS) of blood plasma and nitric oxide (NO).Methods: An intragastric pressure detector and radioimmunoassay (RIA) and biochemical assay are used to determine changes of pyloric pressure and frequency, contents of SS and NO of blood plasma after EA stimulation of different acupoints. Results: Following EA of Zusanli (ST 36), the total pressure, basic pressure and systolic frequency of the sphincter muscle of pylorus lowered, plasma SS content decreased and NO content increased. After EA of Shangjuxu (ST 37), the total pressure, basic pressure and systolic frequency of the sphincter muscle of pylorus decreased, plasrna NO content increased but changes of these indexes are less obvious than those of EA of Zusanli (ST 36). These indexes in other groups had no any apparent changes. Conclusion: EA could lower pyloric pressure and systolic frequency of the pyloric sphincter muscle, whicb may be the important pathway of EA in regulating functional activities of the stomach and intestines. The effect of EA is associated with the contents of some plasma biological substances affecting pyloric pressure and the action of meridians and acupoints is of specificity to a certain degree.
