Comparison of Intra-Abdominal Pressure Among 3 Prone Positional Apparatuses After Changing From the Supine to the Prone Position and Applying Positive End-Expiratory Pressure in Healthy Euvolemic Patients: A Prospective Observational Study
- Authors
- Kim, Eugene; Kim, Hyun-Chang; Lim, Young-Jin; Kim, Chi-Heon; Sohn, Seil; Chung, Chun-Kee; Kim, Hyoung-Jun; Kang, Hyun; Park, Hee-Pyoung
- Issue Date
- Jan-2017
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- intra-abdominal pressure; prone position; positive end-expiratory pressure
- Citation
- JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY, v.29, no.1, pp 14 - 20
- Pages
- 7
- Journal Title
- JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY
- Volume
- 29
- Number
- 1
- Start Page
- 14
- End Page
- 20
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/4943
- DOI
- 10.1097/ANA.0000000000000257
- ISSN
- 0898-4921
1537-1921
- Abstract
- Background: Positional apparatuses used for the prone position can affect intra-abdominal pressure (IAP). In this study, we compared the IAP after changing to the prone position and applying various positive end-expiratory pressure (PEEP) levels among 3 prone positional apparatuses. Methods: A total of 108 healthy euvolemic patients undergoing elective prone spinal surgery were divided into 3 groups based on the positional apparatus used: the Jackson spinal table was used in group J (n=36), the Wilson frame in group W (n=36), and chest rolls in group C (n=36). The IAP was measured 2 minutes after application of 0, 3, 6, and 9 cm H2O of PEEP. Results: The IAP in the supine position was 6.4 +/- 3.0, 5.9 +/- 2.8, and 7.1 +/- 2.5mm Hg in groups J, C, and W, respectively. After the supine-to-prone positional change, the IAP in the prone position was significantly lower in group J than in groups C and W (2.7 +/- 2.9 vs. 8.9 +/- 4.0 and 12.9 +/- 4.3mm Hg, P<0.01). In the prone position, a PEEP of 9 cm H2O increased the IAP from baseline (zero PEEP) by 1.5 +/- 1.3, 1.6 +/- 1.3, and 1.7 +/- 1.0mm Hg in groups J, C, and W, respectively. Conclusions: The IAP in the prone position was significantly lower using the Jackson table compared with the Wilson frame and chest rolls. A PEEP up to 9 cm H2O can be safely used in healthy euvolemic patients undergoing prone spinal surgery without a clinically significant increase in IAP, irrespective of the type of prone positional apparatus.
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