Reproducibility of bladder pressure measurements in critically ill patients

• Published in: Intensive care medicine 2007-07, Vol.33 (7), p.1195-1198
• Main Authors: KIMBALL, Edward J, MONE, Mary C, WOLFE, Timothy R, BARAGHOSHI, Gabriele K, ALDER, Stephen C
• Format: Article
• Language: English
• Subjects: Abdomen; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bladder; Clinical death. Palliative care. Organ gift and preservation; Compartment syndrome; Critical care; Critical Illness; Data collection; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; Humans; Hypertension; Intensive care; Intensive care medicine; Manometry - standards; Medical sciences; Nurses; Nursing; Observer Variation; Patients; Physiology; Pressure; Prospective Studies; Reproducibility; Reproducibility of Results; Urinary Bladder - physiology; Urodynamics
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-007-0641-z

Intra-abdominal hypertension is an independent cause of multiorgan failure and directly effects other physiological measurements, making it an important factor in the management of critically ill patients, but no clinical studies have investigated the reproducibility of intra-abdominal pressure (IAP) measurement to ensure diagnostic accuracy. This study evaluated the intraobserver and interobserver variability of bladder pressure measurements. Prospective, observational study in a university-based adult surgical intensive care unit. Critically ill patients undergoing intra-abdominal pressure readings, measured by nursing staff. The study compared patient IAP measurements obtained by the same nurse (intraobserver variation) and between two different nurses (interobserver variation) in critical care patients with clinical indications for IAP monitoring. Data related to the nursing technique and performance were observed and collected for each IAP measurement obtained. Good correlation of bladder pressure measurements between the same and different individuals was found. Intraobserver and interobserver Pearson's correlations for measured IAP were 0.934 and 0.950, respectively. A unit protocol for IAP measurement standardization was modified based on observational data collected. Intra-abdominal pressure can be accurately and reliably measured in critically ill patients by utilizing a standardized measurement device combined with a standardized clinical protocol.