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In vitro validation of a novel methodfor continuous intra-abdominalpressure monitoring

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Abstract

Objective

Intra-abdominal pressure (IAP) measurement is important in daily clinical practice. Most measurement techniques vary in automaticity and reproducibility. This study tested a new fully automated continuous technique for IAP measurement, the CiMON.

Methods

Three IAP measurement catheters (a Foley manometer and two balloon-tipped catheters) contained in a 50-ml infusion bag were placed on the bottom of a half open 3-l container. To simulate IAH the container was filled with water using 5 cmH2O increments (0–30 cmH2O). Pressure was estimated by observers using the Foley manometer (IAPFM) and simultaneously recorded using two IAP monitors: IAPspie with Spiegelberg and IAPCiM with CiMON. Observers were blinded to the reference levels. Fifteen observers (three intensivists, four residents, two medical students, and six nurses) conducted three pressure readings at each of the seven pressure levels with the FM technique, giving 315 readings. These were paired with the automated IAPspie and IAPCiM readings and the height of the H2O column.

Results

The intra- and interobserver coefficients of variation (COVA) were low for all methods. There was no difference in the results between specialists, physicians in training, andnurses. Spearman's correlation coefficient (R 2) values for all paired measurements were greater than 0.9, and Bland–Altman analysis comparing the reference H2O column, IAPFM, and IAPspie to IAPCiM showed a very good agreement at all pressure levels (bias –0.1 ± 0.6 cmH2O, 95%CI –0.2 to 0). There was a consistent, low underestimation of the reference H2O pressure by the Spiegelberg technique and a low overestimation at pressures below 20 cmH2O by both other techniques.

Conclusions

All three measurement techniques, IAPFM, IAPspie, and IAPCiM have good agreement with the applied hydrostatic pressure in this in vitro model of IAP measurement.

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Acknowledgements

MLNGM is Founding President of the World Society on Abdominal Compartment Syndrome. MLNGM is member of the medical advisory board of Holtech Medical, Spiegelberg, and Pulsion Medical Systems. MLNGM received royalties from Holtech and Spiegelberg to a total amount of € 2500 in the year 2006, which was invested in organizing the Third WCACS in 2007. MLNGM holds a patent with PMS. The remaining authors have no financial involvement with any organization or entity with a financial interest in or in financial competition with the subject matter or materials discussed in the manuscript.

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Correspondence to Manu L. N. G. Malbrain.

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Malbrain, M.L.N.G., De laet, I., Viaene, D. et al. In vitro validation of a novel methodfor continuous intra-abdominalpressure monitoring. Intensive Care Med 34, 740–745 (2008). https://doi.org/10.1007/s00134-007-0952-0

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