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Intensive Care Medicine

, 37:1620 | Cite as

Does femoral venous pressure measurement correlate well with intrabladder pressure measurement? A multicenter observational trial

  • Bart L. De KeulenaerEmail author
  • Adrian Regli
  • Wojciech Dabrowski
  • Vaxtang Kaloiani
  • Zsolt Bodnar
  • Javier Izura Cea
  • A. Andrey Litvin
  • Wendy A. Davis
  • Anne-Marie Palermo
  • Jan J. De Waele
  • Manu L. L. N. G. Malbrain
Original

Abstract

Purpose

To investigate if femoral venous pressure (FVP) measurement can be used as a surrogate measure for intra-abdominal pressure (IAP) via the bladder.

Methods

This was a prospective, multicenter observational study. IAP and FVP were simultaneously measured in 149 patients. The effect of BMI on IAP was investigated.

Results

The incidences of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) were 58 and 7% respectively. The mean APACHE II score was 22 ± 10, SAPS 2 score 42 ± 20, and SOFA score 9 ± 4. The mean IAP was 11.2 ± 4.5 mmHg versus 12.7 ± 4.7 mmHg for FVP. The bias and precision for all measurements were −1.5 and 3.6 mmHg respectively with the lower and upper limits of agreement being −8.6 and 5.7. When IAP was above 20 mmHg, the bias between IAP and FVP was 0.7 with a precision of 2.0 mmHg (lower and upper limits of agreement −3 and 4.6 respectively). Excluding those with ACS, according to the receiver operating curve analysis FVP = 11.5 mmHg predicted IAH with a sensitivity and specificity of 84.8 and 67.0% (AUC of 0.83 (95% CI 0.81–0.86) with P < 0.001). FVP = 14.5 mmHg predicted IAP above 20 mmHg with a sensitivity of 91.3% and specificity of 68.1% (AUC 0.85 (95% CI 0.79–0.91), P < 0.001). Finally, at study entry, the mean IAP in patients with a BMI less then 30 kg/m2 was 10.6 ± 4.0 mmHg versus 13.8 ± 3.8 mmHg in patients with a BMI ≥ 30 kg/m2 (P < 0.001).

Conclusions

FVP cannot be used as a surrogate measure of IAP unless IAP is above 20 mmHg.

Keywords

Intra-abdominal hypertension Intra-abdominal pressure Abdominal compartment syndrome Femoral venous pressure Catheter-related infection 

Notes

Acknowledgments

To standardize the IAP measurement technique, Wolfe-Tory provided the AbViser bladder monitoring kits to study sites that did not currently use this device, free of charge.

Supplementary material

134_2011_2298_MOESM1_ESM.doc (310 kb)
Supplementary material 1 (DOC 309 kb)

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Copyright information

© Copyright jointly held by Springer and ESICM 2011

Authors and Affiliations

  • Bart L. De Keulenaer
    • 1
    Email author
  • Adrian Regli
    • 1
    • 2
  • Wojciech Dabrowski
    • 3
  • Vaxtang Kaloiani
    • 4
  • Zsolt Bodnar
    • 5
  • Javier Izura Cea
    • 6
  • A. Andrey Litvin
    • 7
    • 9
  • Wendy A. Davis
    • 8
  • Anne-Marie Palermo
    • 1
  • Jan J. De Waele
    • 9
  • Manu L. L. N. G. Malbrain
    • 10
  1. 1.Intensive Care UnitFremantle HospitalFremantleAustralia
  2. 2.Medical SchoolThe University of Notre DameFremantleAustralia
  3. 3.Anaesthesiology and Intensive CareMedical University of LublinLublinPoland
  4. 4.Department of Anesthesiology, Emergency Medicine and Critical CareTbilisi State Medical University Central ClinicTbilisiGeorgia
  5. 5.Department of General SurgeryUniversity of DebrecenDebrecenHungary
  6. 6.Intensive Care MedicineHospital Virgen Del CaminoPamplonaSpain
  7. 7.Department of SurgeryGomel Regional Clinical HospitalGomelBelarus
  8. 8.School of Medicine and PharmacologyUniversity of Western Australia, Fremantle HospitalFremantleAustralia
  9. 9.Ghent University HospitalIntensive Care UnitGhentBelgium
  10. 10.Ziekenhuis Netwerk AntwerpenZNA, Stuivenberg, Intensive Care UnitAntwerpBelgium

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