title: 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.
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±2.5 mm 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±4.3 mm 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±1.0 mm 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.
authors.affiliation: Departments of *Anesthesiology and Pain Medicine ‡Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine §Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul †Department of Anesthesiology and Pain Medicine, Keimyung University Dongsan Hospital, Daegu, South Korea.
authors.forename: Eugene
authors.initials: E
authors.lastname: Kim
authors.forename: Hyun-Chang
authors.initials: HC
authors.lastname: Kim
authors.forename: Young-Jin
authors.initials: YJ
authors.lastname: Lim
authors.forename: Chi-Heon
authors.initials: CH
authors.lastname: Kim
authors.forename: Seil
authors.initials: S
authors.lastname: Sohn
authors.forename: Chun-Kee
authors.initials: CK
authors.lastname: Chung
authors.forename: Hyoung-Jun
authors.initials: HJ
authors.lastname: Kim
authors.forename: Hyun
authors.initials: H
authors.lastname: Kang
authors.forename: Hee-Pyoung
authors.initials: HP
authors.lastname: Park
mesh_terms: D034841:Abdominal Cavity / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000295:instrumentation* / Q000379:methods*; D011175:Positive-Pressure Respiration; D016684:Prone Position / Q000502:physiology; D011446:Prospective Studies; D013131:Spine / Q000601:surgery*; D016683:Supine Position / Q000502:physiology; D055815:Young Adult