Abstract
Objective
To investigate the effect of different reference transducer positions on intra-abdominal pressure (IAP) measurement. Three reference levels were studied: the symphysis pubis; the phlebostatic axis; and the midaxillary line at the level of the iliac crest.
Design
Prospective cohort study.
Setting
The intensive care units of participating hospitals
Patients and participants
One hundred thirty-two critically ill patients at risk for intra-abdominal hypertension (IAH).
Interventions
In each patient, three sets of IAP measurements were obtained in the supine position, using the different reference levels. The IAP measurements obtained at the different reference levels were compared using a paired t-test and Bland–Altman statistics were calculated.
Measurements and results
IAPphlebostatic (9.9 ± 4.67 mmHg) and IAPpubis (8.4 ± 4.60 mmHg) were significantly lower that IAPmidax (12.2 ± 4.66 mmHg; p < 0.0001 for both comparisons). The bias between the IAPmidax and IAPpubis was 3.8 mmHg (95% CI 3.5–4.1) and 2.3 mmHg (95% CI 1.9–2.6) between the IAPmidax and the IAPphlebostatic. The precision was 3.03 and 3.40, respectively.
Conclusions
In the supine position, IAPmidax is higher than both IAPphlebostatic and IAPpubis, differences found to be clinically significant; therefore, the symphysis pubis or phlebostatic axis reference lines are not interchangeable with the midaxillary level.
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References
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Acknowledgements
This work was supported by an unrestricted grant from Wolfe-Tory Medical.
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This study was performed on behalf of the Clinical Trials Working Group of the World Society for Abdominal Compartment Syndrome. It was presented at the 2007 World Congress on the Abdominal Compartment Syndrome, Antwerp, Belgium.
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De Waele, J.J., De laet, I., De Keulenaer, B. et al. The effect of different reference transducer positions on intra-abdominal pressure measurement: a multicenter analysis. Intensive Care Med 34, 1299–1303 (2008). https://doi.org/10.1007/s00134-008-1098-4
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DOI: https://doi.org/10.1007/s00134-008-1098-4