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

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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.

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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.

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Correspondence to Bart L. De Keulenaer.

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De Keulenaer, B.L., Regli, A., Dabrowski, W. et al. Does femoral venous pressure measurement correlate well with intrabladder pressure measurement? A multicenter observational trial. Intensive Care Med 37, 1620–1627 (2011). https://doi.org/10.1007/s00134-011-2298-x

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  • DOI: https://doi.org/10.1007/s00134-011-2298-x

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