Reviewer's report
Title:Increasing abdominal pressure with and without PEEP: Effects on
intra-peritoneal, intra-organ and intra-vascular pressures
Version: 3Date:9 March 2010
Reviewer: Franco Valenza
Reviewer's report:
“Dr Jakob and collaegues in their revised manuscript entitled “Increasing
abdominal pressure with and without PEEP: effects on intra-peritoneal,
intra-organ and intravascular pressures” have addressed most of this reviewer’s
criticisms. The manuscript is now much improved.
There still is some confusion to the reader on the main line of discussion the
author’s themselves use to interpret their data. In the objective of the abstract
they state: “The aim of … the study was to asses whether using additional PEEP
to increase abdominal pressure interferes with the accuracy of pressure
estimation at different measurement sites”. At the end of the introduction they
state: “We hypothesized that increased IAP decreases during PEEP release, and
that this effect is more pronounced in the upper abdomen and intra-vascularly”.
At the beginning of the discussion: “ The main finding of this study is that
changing PEEP between 0 and 10 …did not modify the pressure changes
induced by external abdominal pressure…….”.In they conclusion they state: “
….our data suggest tat external abdominal pressure induces similar pressure
changes intra peritoneally, and in urinary bladder, stomach and inferior vena
cava……..”
The author’s, according to this reviewer, need to point clearly in their objectives
and conclusions, the role of weight and PEEP on the different measurement
techniques. Under this light the role of absolute measurements and changes over
PEEP/IAP interaction levels need to be discussed, particularly given the now
mentioned clinical limitations of the investigation, possibly also better discussing
the role of higher and lower abdominal pressures.
Reviewer's report
Title:Increasing abdominal pressure with and without PEEP: Effects on
intra-peritoneal, intra-organ and intra-vascular pressures
Version: 3Date:9 March 2010
Reviewer: Franco Valenza
Reviewer's report:
“Dr Jakob and collaegues in their revised manuscript entitled “Increasing
abdominal pressure with and without PEEP: effects on intra-peritoneal,
intra-organ and intravascular pressures” have addressed most of this reviewer’s
criticisms. The manuscript is now much improved.
There still is some confusion to the reader on the main line of discussion the
author’s themselves use to interpret their data. In the objective of the abstract
they state: “The aim of … the study was to asses whether using additional PEEP
to increase abdominal pressure interferes with the accuracy of pressure
estimation at different measurement sites”. At the end of the introduction they
state: “We hypothesized that increased IAP decreases during PEEP release, and
that this effect is more pronounced in the upper abdomen and intra-vascularly”.
At the beginning of the discussion: “ The main finding of this study is that
changing PEEP between 0 and 10 …did not modify the pressure changes
induced by external abdominal pressure…….”.In they conclusion they state: “
….our data suggest tat external abdominal pressure induces similar pressure
changes intra peritoneally, and in urinary bladder, stomach and inferior vena
cava……..”
The author’s, according to this reviewer, need to point clearly in their objectives
and conclusions, the role of weight and PEEP on the different measurement
techniques. Under this light the role of absolute measurements and changes over
PEEP/IAP interaction levels need to be discussed, particularly given the now
mentioned clinical limitations of the investigation, possibly also better discussing
the role of higher and lower abdominal pressures.
Please review this paper.
user
Reviewer's report
Title:Increasing abdominal pressure with and without PEEP: Effects on
intra-peritoneal, intra-organ and intra-vascular pressures
Version: 3Date:9 March 2010
Reviewer: Franco Valenza
Reviewer's report:
“Dr Jakob and collaegues in their revised manuscript entitled “Increasing
abdominal pressure with and without PEEP: effects on intra-peritoneal,
intra-organ and intravascular pressures” have addressed most of this reviewer’s
criticisms. The manuscript is now much improved.
There still is some confusion to the reader on the main line of discussion the
author’s themselves use to interpret their data. In the objective of the abstract
they state: “The aim of … the study was to asses whether using additional PEEP
to increase abdominal pressure interferes with the accuracy of pressure
estimation at different measurement sites”. At the end of the introduction they
state: “We hypothesized that increased IAP decreases during PEEP release, and
that this effect is more pronounced in the upper abdomen and intra-vascularly”.
At the beginning of the discussion: “ The main finding of this study is that
changing PEEP between 0 and 10 …did not modify the pressure changes
induced by external abdominal pressure…….”.In they conclusion they state: “
….our data suggest tat external abdominal pressure induces similar pressure
changes intra peritoneally, and in urinary bladder, stomach and inferior vena
cava……..”
The author’s, according to this reviewer, need to point clearly in their objectives
and conclusions, the role of weight and PEEP on the different measurement
techniques. Under this light the role of absolute measurements and changes over
PEEP/IAP interaction levels need to be discussed, particularly given the now
mentioned clinical limitations of the investigation, possibly also better discussing
the role of higher and lower abdominal pressures.
assistant