Fetner Melissa, Prittie Jennifer
Emergency and Critical Care Department, The Animal Medical Center, New York, NY, 10065, USA.
J Vet Emerg Crit Care (San Antonio). 2012 Apr;22(2):230-8. doi: 10.1111/j.1476-4431.2012.00725.x. Epub 2012 Apr 5.
To (1) evaluate intra-abdominal pressure (IAP) measurements in dogs with possible risk factors for the development of intra-abdominal hypertension (IAH); (2) determine intra-observer variability of IAP measurements; and (3) determine interobserver variability of IAP measurements.
Prospective, observational, pilot study.
Veterinary teaching hospital.
Fourteen client-owned dogs, requiring urinary catheterization, admitted to the ICU.
Using the risk factors for IAH established for human patients as defined by the World Society of Abdominal Compartment Syndrome, dogs were assigned to either an IAH risk or no risk group. A commercially available IAP monitoring system was used to obtain 3 direct, transvesical IAP measurements. The primary investigator obtained the first 2 IAP measurements. A secondary investigator obtained the third IAP measurement.
Dogs in the IAH risk group (n = 9/14) had significantly higher mean IAPs (9.4 ± 3.4 mm Hg) than dogs in the no risk group (n = 5/14; 4.1 ± 0.9 mm Hg) (P < 0.05). Measurements recorded by the primary investigator were compared to determine intra-observer variability. Pearson's correlation coefficient was 0.98 (P < 0.0001). Bland-Altman analysis determined a mean difference in IAP measurements of -0.3 mm Hg (95% confidence interval from 0.13 to -0.71 mm Hg) indicating an intra-observer variability of less than 0.8 mm Hg. Measurements recorded by the primary and secondary investigator were compared to determine interobserver variability. Pearson's correlation coefficient was 0.95 (P < 0.0001). Bland-Altman analysis determined a mean difference in IAP measurements of 0 mm Hg (95% confidence interval from 1.1 to -1.1 mm Hg) indicating an interobserver variability of less than 2.0 mm Hg.
Dogs with predefined human risk factors for IAH had higher IAP than dogs without risk factors. IAP monitoring appears to have low variability within and across observers.
(1)评估具有腹腔内高压(IAH)发生潜在危险因素的犬的腹腔内压力(IAP)测量值;(2)确定IAP测量值的观察者内变异性;(3)确定IAP测量值的观察者间变异性。
前瞻性、观察性、试点研究。
兽医教学医院。
14只入住重症监护病房(ICU)且需要导尿的客户拥有的犬。
根据世界腹腔间隔综合征协会定义的人类患者IAH危险因素,将犬分为IAH风险组或无风险组。使用市售的IAP监测系统进行3次经膀胱直接IAP测量。主要研究者获取前2次IAP测量值。次要研究者获取第3次IAP测量值。
IAH风险组的犬(n = 9/14)平均IAP(9.4±3.4 mmHg)显著高于无风险组的犬(n = 5/14;4.1±0.9 mmHg)(P < 0.05)。比较主要研究者记录的测量值以确定观察者内变异性。Pearson相关系数为0.98(P < 0.0001)。Bland-Altman分析确定IAP测量值的平均差异为 -0.3 mmHg(95%置信区间为0.13至 -0.71 mmHg),表明观察者内变异性小于0.8 mmHg。比较主要研究者和次要研究者记录的测量值以确定观察者间变异性。Pearson相关系数为0.95(P < 0.0001)。Bland-Altman分析确定IAP测量值的平均差异为0 mmHg(95%置信区间为1.1至 -1.1 mmHg),表明观察者间变异性小于2.0 mmHg。
具有预定义的人类IAH危险因素的犬比无危险因素的犬IAP更高。IAP监测在观察者内和观察者间似乎具有较低的变异性。