Center for Clinical Research (CIC), Fundación Valle del Lili, Carrera 98 No. 18-49, Torre 7, Piso 3 (CIC), Cali, Colombia.
Department of Surgery, Fundación Valle del Lili, Carrera 98 No. 18-49, Cali, Colombia.
World J Surg. 2020 Jun;44(6):1706-1711. doi: 10.1007/s00268-020-05392-7.
Abdominal compartment syndrome is a sustained intra-abdominal pressure (IAP) >20 mm Hg associated with new organ dysfunction. In order to prevent its development and related complications, IAP monitoring should be performed in patients with risk factors. Although techniques for its monitoring have been developed, they are of high cost and not always available in low- and lower-middle-income countries. Therefore, we aim to develop and validate in a bench model a handcrafted catheter to be used as an alternative method to measure the intra-gastric pressure (IGP) as a surrogate of the IAP.
We used an acrylic water container as a model of the abdomen and four handcrafted catheters made of a 16 Fr Levin tube with a globe finger tied with silk in the distal end, inflated with 1 cm of air. They were placed on the bottom of the container where the water pressure was directly measured as a gold standard. The agreement between the two measures was assessed with the Bland-Altman method.
We performed 120 simultaneous measures. The mean pressure difference was 0.218 (95% CI 0.074 to 0.363).
The handcrafted prototype catheter and the direct measure were highly correlated. The new catheter is a reliable and reproducible tool for pressure monitoring. However, before it can be used in the clinical setting for IAP monitoring, validation in human models in a real clinical setting needs to be performed.
腹腔间隔室综合征是一种持续的腹腔内压(IAP)>20mmHg 伴新发器官功能障碍。为了预防其发生和相关并发症,应在有危险因素的患者中进行 IAP 监测。虽然已经开发出了监测技术,但它们成本高,在中低收入国家并不总是可用。因此,我们旨在开发并在一个台架模型中验证一种手工制作的导管,作为替代方法来测量胃内压(IGP),作为 IAP 的替代指标。
我们使用一个丙烯酸水箱作为腹部模型,使用四个由 16Fr Levin 管制成的手工制作的导管,在远端用丝线系上一个球状物,充气 1cm 的空气。它们被放置在容器底部,水压力直接在那里测量作为金标准。两种测量方法之间的一致性用 Bland-Altman 方法进行评估。
我们进行了 120 次同步测量。平均压力差为 0.218(95%CI 0.074 至 0.363)。
手工制作的原型导管和直接测量高度相关。新的导管是一种可靠且可重复的压力监测工具。然而,在将其用于临床 IAP 监测之前,需要在真实临床环境中的人体模型中进行验证。