Intensive Care Unit, Fremantle Hospital, 1 Alma Street, Fremantle, WA 6160, Australia.
Intensive Care Med. 2011 Oct;37(10):1620-7. doi: 10.1007/s00134-011-2298-x. Epub 2011 Jul 8.
To investigate if femoral venous pressure (FVP) measurement can be used as a surrogate measure for intra-abdominal pressure (IAP) via the bladder.
This was a prospective, multicenter observational study. IAP and FVP were simultaneously measured in 149 patients. The effect of BMI on IAP was investigated.
The incidences of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) were 58 and 7% respectively. The mean APACHE II score was 22 ± 10, SAPS 2 score 42 ± 20, and SOFA score 9 ± 4. The mean IAP was 11.2 ± 4.5 mmHg versus 12.7 ± 4.7 mmHg for FVP. The bias and precision for all measurements were -1.5 and 3.6 mmHg respectively with the lower and upper limits of agreement being -8.6 and 5.7. When IAP was above 20 mmHg, the bias between IAP and FVP was 0.7 with a precision of 2.0 mmHg (lower and upper limits of agreement -3 and 4.6 respectively). Excluding those with ACS, according to the receiver operating curve analysis FVP = 11.5 mmHg predicted IAH with a sensitivity and specificity of 84.8 and 67.0% (AUC of 0.83 (95% CI 0.81-0.86) with P < 0.001). FVP = 14.5 mmHg predicted IAP above 20 mmHg with a sensitivity of 91.3% and specificity of 68.1% (AUC 0.85 (95% CI 0.79-0.91), P < 0.001). Finally, at study entry, the mean IAP in patients with a BMI less then 30 kg/m(2) was 10.6 ± 4.0 mmHg versus 13.8 ± 3.8 mmHg in patients with a BMI ≥ 30 kg/m(2) (P < 0.001).
FVP cannot be used as a surrogate measure of IAP unless IAP is above 20 mmHg.
通过膀胱研究探讨股静脉压（FVP）测量是否可作为腹腔内压（IAP）的替代测量方法。
这是一项前瞻性、多中心观察性研究。149 例患者同时测量 IAP 和 FVP。研究了 BMI 对 IAP 的影响。
腹腔内高压（IAH）和腹室间隔综合征（ACS）的发生率分别为 58%和 7%。平均 APACHE II 评分为 22±10，SAPS 2 评分为 42±20，SOFA 评分为 9±4。平均 IAP 为 11.2±4.5mmHg，FVP 为 12.7±4.7mmHg。所有测量的偏倚和精度分别为-1.5mmHg 和 3.6mmHg，一致性界限的下限和上限分别为-8.6mmHg 和 5.7mmHg。当 IAP 高于 20mmHg 时，IAP 和 FVP 之间的偏差为 0.7mmHg，精度为 2.0mmHg（一致性界限的下限和上限分别为-3mmHg 和 4.6mmHg）。排除 ACS 患者后，根据接收者操作曲线分析，FVP=11.5mmHg 预测 IAH 的灵敏度和特异性分别为 84.8%和 67.0%（AUC 为 0.83（95%CI 0.81-0.86），P<0.001）。FVP=14.5mmHg 预测 IAP 高于 20mmHg 的灵敏度为 91.3%，特异性为 68.1%（AUC 为 0.85（95%CI 0.79-0.91），P<0.001）。最后，在研究开始时，BMI 小于 30kg/m2 的患者的平均 IAP 为 10.6±4.0mmHg，BMI 大于等于 30kg/m2 的患者为 13.8±3.8mmHg（P<0.001）。
除非 IAP 高于 20mmHg，否则 FVP 不能用作 IAP 的替代测量方法。
