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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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Published in: | Intensive care medicine 2008-04, Vol.34 (4), p.740-745 |
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Main Authors: | , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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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. |
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ISSN: | 0342-4642 1432-1238 |
DOI: | 10.1007/s00134-007-0952-0 |