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Title: | Is it feasible to measure intra-abdominal pressure using a balloon-tipped rectal catheter? Results of a validation study | Authors: | STAELENS, Anneleen Heymans , Ann Christiaens, Sigrid Van Regenmortel, Niels GYSELAERS, Wilfried Malbrain, Manu L. N. G. |
Issue Date: | 2023 | Publisher: | SPRINGER HEIDELBERG | Source: | Journal of Clinical Monitoring and Computing, 37 (1), p. 287-296 | Abstract: | The gold standard to measure intra-abdominal pressure (IAP) is intra-vesical measurement via the urinary bladder. However, this technique is restricted in ambulatory settings because of the risk of iatrogenic urinary tract infections. Rectal IAP measurements (IAP(rect)) may overcome these limitations, but requires validation. This validation study compares the IAP(rect) technique against gold standard intra-vesical IAP measurements (IAP(ves)). IAP(rect) using an air-filled balloon catheter and IAP(ves) using Foley Manometer Low Volume were measured simultaneously in sedated and ventilated patients. Measurements were performed twice in different positions (supine and HOB 45 degrees elevated head of bed) and with an external abdominal pressure belt. Sixteen patients were included. Seven were not eligible for analysis due to unreliable IAP(rect) values. IAP(rect) was significantly higher than IAP(ves) for all body positions (p < 0.01) and the correlation between IAP(ves) and IAP(rect) was poor and not significant in each position (p >= 0.25, R-2 < 0.6, Lin's CCC < 0.8, bias - 8.1 mmHg and precision of 5.6 mmHg with large limits of agreement between - 19 to 2.9 mmHg, high percentage error 67.3%, and low concordance 86.2%). Repeatability of IAP(rect) was not reliable (R = 0.539, p = 0.315). For both techniques, measurements with the external abdominal pressure belt were significantly higher compared to those without (p < 0.03). IAP(rect) has important shortcomings making IAP estimation using a rectal catheter unfeasible because the numbers cannot be trusted nor validated. | Notes: | Malbrain, MLNG (corresponding author), Med Univ Lublin, Dept Anaesthesiol & Intens Therapy 1, Jaczewskiego St 8, PL-20954 Lublin, Poland.; Malbrain, MLNG (corresponding author), Medaman, Med Data Management, B-2440 Geel, Belgium.; Malbrain, MLNG (corresponding author), Int Fluid Acad, Dreef 3, B-3360 Lovenjoel, Belgium. anneleen.staelens@gmail.com; heymansann1@gmail.com; christiaens.sigrid@gmail.com; niels.vanregenmortel@zna.be; wilfried.gyselaers@zol.be; manu.malbrain@telenet.be |
Keywords: | Intra-abdominal pressure;Rectal measurement;Intra-vesical measurement;Validation;Abdominal hypertension;Monitoring | Document URI: | http://hdl.handle.net/1942/38027 | ISSN: | 1387-1307 | e-ISSN: | 1573-2614 | DOI: | 10.1007/s10877-022-00890-6 | ISI #: | 000833451300001 | Rights: | The Author(s) 2022 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2023 |
Appears in Collections: | Research publications |
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