Eastern J Med. 2019; 24(2): 235-241 | DOI: 10.5505/ejm.2019.50023

Effects of increasing Positive End-Expiratory Pressure (PEEP) values on intraabdominal pressure and hemodynamics: A prospective clinical study

UÐUR SERKAN DUMANLIDAй, NUREDDIN YUZKAT², Celaleddin Soyalp², NURÇIN GÜLHAS^2
1Department Of Anesthesiology And Reanimation, Aksaray Ortaköy State Hospital, Aksaray, Turkey
²Department Of Anesthesiology And Reanimation, Van Yuzuncu Yil University, Van, Turkey

INTRODUCTION: In the present study, the purpose was to compare the effects of Positive End-Expiratory Pressure (PEEP), which is applied to intensive care patients, on Intraabdominal Pressure (IAP) and hemodynamic parameters.
METHODS: The patients were selected from among the patients who received mechanical ventilator support and PEEP at various levels in Intensive Care Unit, who were between 18-80 years of age, who did not have abdominal surgery.In the present study, a total of 64 patients were divided into 3 groups.Those who had PEEP value at 4 cmH2O were included as Group 4, those with PEEP value between 5-8 cmH2O were included in Group 8, and those with PEEP value between 9-12 cmH2O were included in Group 12.The intraabdominal pressures, central venous and arterial blood pressures, heart rates, peripheral oxygen saturation values, body temperatures, fluid balances and urine volumes were measured at 0, 6, 12, 18 and 24th hours.The Intra-Bladder Pressure Measurement Method was employed to measure the intra-abdominal pressure.
RESULTS: The lowest IAP values were measured in Group 4, and the highest values were measured in Group 12.The IAP values that were measured in Group 12 were higher than the other groups at a significant level.The intra and inter-group blood pressures, body temperatures, urine outputs, central venous pressures, and fluid balance values were similar in all groups.
DISCUSSION AND CONCLUSION: In the present study, it was concluded that IAP was low in low PEEP values, and the IAP was high in higher PEEP levels; and this increase caused mild intrabdominal hypertension; however, did not affect hemodynamics.

Keywords: hemodynamics, intraabdominal pressure, mechanical ventilation, Positive End-Expiratory Pressure, Intensive Care Units

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