Wauters Joost, Spincemaille Liesbeth, Dieudonne Anne-Sophie, Van Zwam Kenny, Wilmer Alexander, Malbrain Manu L N G
Medical Intensive Care Unit, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.
Crit Care Res Pract. 2012;2012:181563. doi: 10.1155/2012/181563. Epub 2012 Feb 20.
Background. Intravesical pressure (IAP(ivp)) measurement is considered to be the gold standard for assessment of intra-abdominal pressure (IAP). This study evaluated a new minimally invasive IAP monitoring device (CiMON) against three other devices in a wide range of clinically relevant IAP and in different body positions in healthy pigs. Methods. The CiMON catheter (IAP(CiM)) and another balloon-tipped catheter (IAP(spie)) were positioned into the stomach. Fluid-filled catheters were used for direct intraperitoneal (IAP(dir)) and IAP(ivp) measurement. Both in supine and 25° head-of-bed positions, IAP was increased from baseline to 30 mmHg. At every IAP level, 4 IAP measurements were recorded simultaneously. Mean differences and the limits of agreement were calculated. Results. Bias between IAP(CiM) and IAP(spie) was nearly zero with very good agreement, both in supine and 25° position. In supine position, IAP(CiM) slightly overestimated IAP(ivp) and IAP(dir) by 1.5 and 2.1 mmHg with reasonable agreement. In 25° position, IAP(CiM) underestimated IAP(ivp) and IAP(dir) by 1.0 and 0.5 mmHg, again with reasonable agreement. Conclusions. Agreement between IAP(CiM) and IAP(spie) was very good, while good-to-moderate agreement exists between IAP(CiM) and IAP(dir) or IAP(ivp). Simplicity, continuous monitoring, and the combination with a feeding tube should lead to further clinical studies, evaluating this new CiMON device.
背景。膀胱内压(IAP(ivp))测量被认为是评估腹内压(IAP)的金标准。本研究在健康猪的一系列临床相关IAP水平及不同体位下,将一种新型微创IAP监测设备(CiMON)与其他三种设备进行了比较。方法。将CiMON导管(IAP(CiM))和另一根带气囊导管(IAP(spie))置于胃内。使用充液导管进行直接腹腔内(IAP(dir))和IAP(ivp)测量。在仰卧位和床头抬高25°位时,IAP均从基线水平升高至30 mmHg。在每个IAP水平,同时记录4次IAP测量值。计算平均差异和一致性界限。结果。IAP(CiM)与IAP(spie)之间的偏差几乎为零,一致性非常好,在仰卧位和25°位均如此。在仰卧位时,IAP(CiM)对IAP(ivp)和IAP(dir)的估计略高,分别高1.5 mmHg和2.1 mmHg,一致性合理。在25°位时,IAP(CiM)对IAP(ivp)和IAP(dir)的估计略低,分别低1.0 mmHg和0.5 mmHg,一致性同样合理。结论。IAP(CiM)与IAP(spie)之间的一致性非常好,而IAP(CiM)与IAP(dir)或IAP(ivp)之间存在良好至中等程度的一致性。其操作简单、可连续监测以及与饲管相结合的特点,应能促使进一步的临床研究来评估这种新型CiMON设备。