Abstract
Objective
To describe a direct intra-abdominal pressure (IAP) measurement technique using a solid microsensor comparing its values with the ones simultaneously obtained by means of Kron’s technique. Comparative study between two different methods to measure intra-abdominal pressure in a multidisciplinary intensive care unit of a university hospital.
Methods
In 11 critical patients considered irreversibly ill, IAP was simultaneously measured via Kron’s technique (IAPK) and by direct measure (IAPC) through an abdominal tap with a Codman microsensor, inserted through it. Several measurements were obtained at different PEEP levels (0, 10 and 20 cm of H20) and bed inclination (0°, 40° and 60°).
Results
92 simultaneous measurements of IAPK and IAPC were made. The difference between both measurements (mean ± SD) were: 0.286 ± 0.938 mmHg. The correlation coefficient was r = 0.98. Bland-Altman plot showed a narrow distribution: 95% of the differences were between 1.87 mmHg of each averaged value. No complications with IAPC measurements were found.
Conclusions
Direct IAP measurement with a Codman microsensor allows continuous monitoring without urinary tract manipulation, is simple to use and to calibrate, minimally invasive and appropriate for patients at risk to develop abdominal compartmental syndrome. Due to its cost it should be reserved for selected critical patients where standard techniques are contraindicated or can be inaccurate.
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References
Hamernik J. “Das Herz andesine Bewegung”, 1858; quoted by Duomarco J, Rimini R, en “ La presión intraabdominal en el hombre”, Buenos Aires: El Ateneo, 1947: 95–119
Sugrue M, Jones F, Lee A, Buist MD, Deane S, Bauman A, Hillman K (1996) Intraabdominal pressure and gastric intramucosal pH: is there an association? World J Surg 20(8):988–991
Cullen DJ, Coyle JP, Teplick R, Long MC (1989) Cardiovascular, pulmonary, and renal effects of massively increased intraabdominal pressure in critically ill patients. Crit Care Med 17(2):118–121
Harman PK, Kron IL, McLachlan HD, Freedlender AE, Nolan SP (1982) Elevated intraabdominal pressure and renal function. Ann Surg 196(5):594–597
Bloomfield G, Ridings P, Blocher R, Marmarou A, Sugerman H (1997) A proposed relationship between increased intraabdominal, intrathoracic, and intracranial pressure. Crit Care Med 25(3):496–503
Kron IL, Harman PK, Nolan SP (1984) The measurement of intraabdominal pressure as a criterion for abdominal reexploration. Ann Surg 199(1):28–30
Cheatham M, Safcsak K (1998) Intraabdominal pressure: a revised method for measurement. J Am Coll Surg 186(5):594–595
Iberti TJ, Kelly KM, Gentili DR, Hirsch S, Benjamin E (1987) A simple technique to accurately determine intra-abdominal pressure. Crit Care Med 15(12):1140–1142
Iberti TJ, Lieber CE, Benjamin E (1989) Determination of intra-abdominal pressure using a transurethral bladder catheter: clinical validation of the technique. Anesthesiology 70:47–50
International abdominal compartment syndrome consensus definitions conference committee 2004. http://www.WSACS. ORG
De Waele J, Pletinckx P, Blot S, Hoste E (2006) Saline volume in transvesical intraabdominal ressure measurement: enough is enough. Intensive Care Med 32:455–459
Fusco M, Martin S, Chang C (2001) Estimation of intra-abdominal pressure by bladder pressure measurement: validity and methodology. J Trauma 50(2):297–302
Hodgson NF, Stewart TC, Girotti MJ (2000) Open or closed diagnostic peritoneal lavage for abdominal trauma? A meta-analysis. J Trauma 48(6):1091–1095
Thomsen TD, Shaffer RW, White B, Setnik GS. Paracentesis. N Engl J Med 2006; 355: e21
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Pracca FF, Biestro AA, Moraes L, Puppo CB, Calvo SM, Gorrasi J, Cancela M. Direct measurement of intra-abdominal pressure with a solid microtranducer.
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Pracca, F., Biestro, A., Moraes, L. et al. Direct Measurement of Intra-Abdominal Pressure with a Solid Microtranducer. J Clin Monit Comput 21, 167–170 (2007). https://doi.org/10.1007/s10877-007-9071-2
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DOI: https://doi.org/10.1007/s10877-007-9071-2