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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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Authors and Affiliations

  1. Intensive Care Unit, Fremantle Hospital, 1 Alma Street, Fremantle, WA, 6160, Australia

    Bart L. De Keulenaer, Adrian Regli & Anne-Marie Palermo

  2. Medical School, The University of Notre Dame, Fremantle, WA, Australia

    Adrian Regli

  3. Anaesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland

    Wojciech Dabrowski

  4. Department of Anesthesiology, Emergency Medicine and Critical Care, Tbilisi State Medical University Central Clinic, Tbilisi, Georgia

    Vaxtang Kaloiani

  5. Department of General Surgery, University of Debrecen, Debrecen, Hungary

    Zsolt Bodnar

  6. Intensive Care Medicine, Hospital Virgen Del Camino, Servicio Novarro de Salud, Pamplona, Navarra, Spain

    Javier Izura Cea

  7. Department of Surgery, Gomel Regional Clinical Hospital, Gomel, Belarus

    A. Andrey Litvin

  8. School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, WA, Australia

    Wendy A. Davis

  9. Ghent University Hospital, Intensive Care Unit, Ghent, Belgium

    A. Andrey Litvin & Jan J. De Waele

  10. Ziekenhuis Netwerk Antwerpen, ZNA, Stuivenberg, Intensive Care Unit, Antwerp, Belgium

    Manu L. L. N. G. Malbrain

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  1. Bart L. De Keulenaer
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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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