Turnbull D, Webber S, Hamnegard C H, Mills G H
Academic Unit of Anaesthesia, Sheffield University, and Department of Anaesthesia, Royal Hallamshire Hospital, UK.
Br J Anaesth. 2007 May;98(5):628-34. doi: 10.1093/bja/aem060.
The diagnosis of abdominal compartment syndrome depends upon the demonstration of an elevated intra-abdominal pressure (IAP). Direct measures of IAP are impractical in the critical care unit; intravesical pressure (IVP) and intragastric pressure (IGP) should represent acceptable surrogate measures. IVP is the preferred measure of IAP in critical care. We considered that IGP represents a practical alternative. The objective of this preliminary study was to observe the relationship between IGP and IAP.
After Institutional Ethics Board approval, 29 patients having elective laparoscopic surgery were recruited. IAP was measured directly via the abdominal trochar. This was compared with IGP measured via a commercial balloon catheter placed into the stomach.
Measured IGP was always more positive than IAP; both showed linear correlation (r2>0.9). When IGP was calibrated against IAP, an estimated difference between the IGP and IAP of+/-2.5 mm Hg for 95% of the measurements was seen.
The study demonstrates the strength of the relationship between IGP and IAP in normal individuals. Application of IGP measurement in the critical care patient is necessary to demonstrate its suitability for continuous IAP assessment.
腹腔间隔室综合征的诊断取决于腹内压（IAP）升高的证据。在重症监护病房直接测量IAP并不实际；膀胱内压（IVP）和胃内压（IGP）应是可接受的替代测量方法。IVP是重症监护中IAP的首选测量方法。我们认为IGP是一种实用的替代方法。这项初步研究的目的是观察IGP与IAP之间的关系。
经机构伦理委员会批准后，招募了29例行择期腹腔镜手术的患者。通过腹部套管针直接测量IAP。将其与通过放置在胃内的商用气囊导管测量的IGP进行比较。
测得的IGP总是比IAP更正；两者均呈线性相关（r2>0.9）。当根据IAP校准IGP时，95%的测量值显示IGP与IAP之间的估计差值为±2.5 mmHg。
该研究证明了正常个体中IGP与IAP之间关系的强度。在重症监护患者中应用IGP测量以证明其适用于连续IAP评估是必要的。
