Can selection of mechanical ventilation mode prevent increased intra-abdominal pressure in patients admitted to the intensive care unit?

Increased intra-abdominal pressure [IAP] results in dysfunction of vital organs. The aim of the present study was to evaluate the effect of mechanical ventilation mode on IAP. In a cohort study, a total of 60 patients aged 20-70 years who were admitted to the ICU and underwent mechanical ventilation were recruited. Mechanical ventilation included one of the three modes: Biphasic positive airway pressure [BIPAP] group, synchronize intermittent mandatory ventilation [SIMV] group, or continuous positive airway pressure [CPAP] group. For each patient, mechanical ventilation mode and its parameters, blood pressure, SpO2, and status of tube feeding and IAP were recorded. Our findings indicate that the study groups were not significantly different in terms of anthropometric characteristics including age [64.5 +/- 4, P = 0.1], gender [male/female 31/29, P = 0.63], and body mass index [24 +/- 1.2, P = 0.11]. Increase IAP was related to the type of respiratory mode with the more increased IAP observed in SIMV mode, followed by BIPAP and CPAP modes [P = 0.01]. There were significant correlations between increased IAP and respiratory variables including respiratory rate, pressure support ventilation, and inspiratory pressure [P < 0.05]. Tube feeding tolerance through NG-tube was lower in SIMV group, followed by BIPAP and CPAP groups [P < 0.05]. There is a significant relationship between respiratory modes and IAP; therefore, it is better to utilize those types of mechanical ventilation like CPAP and BIPAP mode in patients who are prone to Intra-abdominal hypertension

[Evaluation of remifentanyl infusion on post anesthetic shivering during rhinoplasty surgery in emem reza hospital]

According to increasing rate of rhinoplastic surgery and need to dry field for this operation. Also since the remifentanyl is one of the best drugs in such operation we have done this study to evaluate one of its side effects [postanesthetic shivering] on patients. It was a randomized clinical trial. In this study 60 patients who were candidate for elective surgery under general anesthesia randomly allocate to two groups [remifentanyl and control groups]. The results were presented as the mean +/- SD. Then data from prevalence and duration of post-anesthetic shivering was analyzed with Chi - square and and T-Student tests and by 18 version of SPSS software. Two groups were similar with demographic parameters such as age, and sex [P>0.05]. In the remifentanyl group frequency of postanesthetic shivering was higher and duration of it was more in remifentanyl group [P<0.05]. Remifentanyl infusion can cause higher rate of postanesthetic shivering than control group.

[Evaluation of pre-medication with oral clonidine on fentanyl induced cough during general anesthesia]

A reflex cough is often observed after intravenous bolus of fentanyl. This study was conducted to determine whether pre-treatment with oral clonidine could attenuate fentanyl-induced cough. Two groups, containing 80 patients each, were candidated for elective surgery under general anesthesia. They were randomly divided into case group, receiving preoperative oral clonidine tablet, and control group, receiving preoperative placebo. Then gathered data was analyzed with Chi - square, Mann-Whitney U, T-Student and Tukey tests by 13 spss software, version 13. The results were evaluated as the mean +/- SD and considered statistically significant for p <0.05. Two groups were similar with demographic parameters as age, weigh and sex [p>0.05]. In the clonidine group severity and frequency of fentanyl induced cough were lower [p<0.05]. The OAA/S scaling score in two groups were similar [p>0.05]. Pre-medication with oral clonidine can effectively attenuate fentanyl-induced cough with an unknown mechanism