INTRA abdominal pressure in normal patients is usually sub-atmospheric to zero. A) But in obese patients INTRA abdominal pressure often is positive, may go up to 12 cms of water and raises with 1) Raise in Sagittal abdominal diameter and 2) More abdominal fat deposition (than other body parts). BMI doesn't correlate...
Raised INTRA abdominal pressure causes Impaired Venous drainage Atelectasis of lung (baby lungs in morbidly obese) Decreased FRC, lung capacities etc Chronic IAP elevation is a cause for systemic hypertension ( compensation for venous stasis, which later leads to vascular stasis) Gastro-oesophageal reflux Pseudotumour cerebri Hernia Obstructive Sleep Apnea, etc Pneumoperitoneum with co2 multiplies this problem. INTRA Abdominal pressure raises very high, if —- Adequate Muscle Relaxation was not given Guarding due to inadequate Analgesia If the surgeon…
