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In vitro validation of a novel methodfor continuous intra-abdominalpressure monitoring

Objective Intra-abdominal pressure (IAP) measurement is important in daily clinical practice. Most measurement techniques vary in automaticity and reproducibility. This study tested a new fully automated continuous technique for IAP measurement, the CiMON. Methods Three IAP measurement catheters (a ...

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Bibliographic Details
Published in:Intensive care medicine 2008-04, Vol.34 (4), p.740-745
Main Authors: Malbrain, Manu L. N. G., De laet, Inneke, Viaene, Dries, Schoonheydt, Karen, Dits, Hilde
Format: Article
Language:English
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Summary:Objective Intra-abdominal pressure (IAP) measurement is important in daily clinical practice. Most measurement techniques vary in automaticity and reproducibility. This study tested a new fully automated continuous technique for IAP measurement, the CiMON. Methods Three IAP measurement catheters (a Foley manometer and two balloon-tipped catheters) contained in a 50-ml infusion bag were placed on the bottom of a half open 3-l container. To simulate IAH the container was filled with water using 5 cmH 2 O increments (0–30 cmH 2 O). Pressure was estimated by observers using the Foley manometer (IAP FM ) and simultaneously recorded using two IAP monitors: IAP spie with Spiegelberg and IAP CiM with CiMON. Observers were blinded to the reference levels. Fifteen observers (three intensivists, four residents, two medical students, and six nurses) conducted three pressure readings at each of the seven pressure levels with the FM technique, giving 315 readings. These were paired with the automated IAP spie and IAP CiM readings and the height of the H 2 O column. Results The intra- and interobserver coefficients of variation (COVA) were low for all methods. There was no difference in the results between specialists, physicians in training, andnurses. Spearman's correlation coefficient ( R 2 ) values for all paired measurements were greater than 0.9, and Bland–Altman analysis comparing the reference H 2 O column, IAP FM , and IAP spie to IAP CiM showed a very good agreement at all pressure levels (bias –0.1 ± 0.6 cmH 2 O, 95%CI –0.2 to 0). There was a consistent, low underestimation of the reference H 2 O pressure by the Spiegelberg technique and a low overestimation at pressures below 20 cmH 2 O by both other techniques. Conclusions All three measurement techniques, IAP FM , IAP spie , and IAP CiM have good agreement with the applied hydrostatic pressure in this in vitro model of IAP measurement.
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-007-0952-0