Direct measurement of intra-abdominal pressure with a solid microtranducer.

OBJECTIVE

To describe a direct intra-abdominal pressure (IAP) measurement technique using a solid microsensor comparing its values with the ones simultaneously obtained by means of Kron's technique. Comparative study between two different methods to measure intra-abdominal pressure in a multidisciplinary intensive care unit of a university hospital.

METHODS

In 11 critical patients considered irreversibly ill, IAP was simultaneously measured via Kron's technique (IAPK) and by direct measure (IAPC) through an abdominal tap with a Codman microsensor, inserted through it. Several measurements were obtained at different PEEP levels (0, 10 and 20 cm of H20) and bed inclination (0 degrees , 40 degrees and 60 degrees ).

RESULTS

92 simultaneous measurements of IAPK and IAPC were made. The difference between both measurements (mean +/- SD) were: 0.286 +/- 0.938 mmHg. The correlation coefficient was r = 0.98. Bland-Altman plot showed a narrow distribution: 95% of the differences were between 1.87 mmHg of each averaged value. No complications with IAPC measurements were found.

CONCLUSIONS

Direct IAP measurement with a Codman microsensor allows continuous monitoring without urinary tract manipulation, is simple to use and to calibrate, minimally invasive and appropriate for patients at risk to develop abdominal compartmental syndrome. Due to its cost it should be reserved for selected critical patients where standard techniques are contraindicated or can be inaccurate.