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一种新型连续腹腔内压力测量设备(SERENNO)的临床前验证

Pre-Clinical Validation of A Novel Continuous Intra-Abdominal Pressure Measurement Equipment (SERENNO).

作者信息

Tayebi Salar, Wise Robert, Pourkazemi Ali, Stiens Johan, Malbrain Manu L N G

机构信息

Department of Electronics and Informatics, Vrije Universiteit Brussel, 1050 Brussels, Belgium.

Adult Intensive Care, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford OX3 7LE, UK.

出版信息

Life (Basel). 2022 Jul 30;12(8):1161. doi: 10.3390/life12081161.

Abstract

Increased intra-abdominal pressure (IAP) has an important impact on morbidity and mortality in critically ill patients. The SERENNO Sentinel system (Serenno Medical, Yokne'am Illit, Israel) is a novel device that allows automatic and continuous IAP measurements. Pre-clinical validation in a bench model study comparing the new device with the gold standard method and two other continuous IAP measurement devices. IAP measurement with the novel SERENNO device (IAP) was compared with the gold standard IAP (water column height) and two other automatic and continuous IAP measurement devices: IAP measured via the CiMON device (Pulsion Medical Systems, Munich, Germany) and IAP measured using the Spiegelberg device (Spiegelberg, Hamburg, Germany), which previously received the CE mark for clinical applications. The IAP measurement was performed six times ( = 6) at each pressure value (between 0 and 35 mmHg) with different methods and the height of the water column in a bench-top phantom was used as the reference IAP for further interpretations. In addition to the quadruple comparisons, intra- and inter-observer variability of IAP measurements were also calculated. Correlation studies and Bland and Altman's analyses were performed in addition to the concordance study. The CiMON and Spiegelberg devices showed a greater dynamic range and standard deviation when recording IAP and IAP compared with IAP. In general, the maximum and minimum values of IAP recorded with each device (at each level of IAP) were significantly different from each other. However, the average values were in very good agreement. The highest correlation was observed between IAP and IAP, and IAP and IAP (R = 0.99, = 0.001 for both comparisons and intra- and inter-observer measurements). Although the CiMON and SERENNO systems were in very good agreement with each other, a slightly smaller correlation coefficient was found between them (R = 0.95, = 0.001, and R = 0.96, = 0.001 for intra- and inter-observer measurements, respectively). When compared to the gold standard (IAP), Bland and Altman's analysis showed a mean difference of +0.44, -0.25, and -0.04 mmHg for the intra-observer measurements and +0.18, -0.75, and -0.58 mmHg for the inter-observer measurements for IAP, IAP, and IAP, respectively. IAP showed a small positive bias (overestimation), while IAP and IAP showed a negative bias (underestimation) when compared to IAP. Further statistical analysis showed a concordance coefficient of 100% with an excellent ability of the SERENNO system in tracking IAP changes. Pre-clinical validation of a new IAP monitoring device (SERENNO) showed very promising results when compared with the gold standard and other continuous techniques; however, clinical trials should be followed as the next stage of the validation process. Based on the actual research guidelines, the SERENNO system can be used interchangeably with the gold standard.

摘要

腹内压升高(IAP)对危重症患者的发病率和死亡率有重要影响。SERENNO Sentinel系统(以色列伊略特市的Serenno Medical公司)是一种新型设备,可实现自动连续测量IAP。在一项台架模型研究中进行临床前验证,将该新设备与金标准方法以及其他两种连续IAP测量设备进行比较。将新型SERENNO设备测量的IAP(IAP)与金标准IAP(水柱高度)以及其他两种自动连续IAP测量设备进行比较:通过CiMON设备(德国慕尼黑的Pulsion Medical Systems公司)测量的IAP和使用Spiegelberg设备(德国汉堡的Spiegelberg公司,该设备先前已获得临床应用的CE标志)测量的IAP。在每个压力值(0至35 mmHg之间)使用不同方法对IAP进行六次测量(n = 6),并将台式模型中的水柱高度用作参考IAP以进行进一步解读。除了四重比较之外,还计算了IAP测量的观察者内和观察者间变异性。除一致性研究外,还进行了相关性研究以及Bland和Altman分析。与IAP相比,CiMON和Spiegelberg设备在记录IAP和IAP时显示出更大的动态范围和标准差。总体而言,每种设备记录的IAP的最大值和最小值(在每个IAP水平)彼此之间存在显著差异。然而,平均值非常吻合。IAP与IAP以及IAP与IAP之间观察到最高的相关性(两次比较以及观察者内和观察者间测量的R = 0.99,P = 0.001)。尽管CiMON和SERENNO系统彼此之间非常吻合,但它们之间的相关系数略小(观察者内测量的R = 0.95,P = 0.001,观察者间测量的R = 0.96,P = 0.001)。与金标准(IAP)相比,Bland和Altman分析显示,IAP、IAP和IAP的观察者内测量的平均差异分别为+0.44、-0.25和-0.04 mmHg,观察者间测量的平均差异分别为+0.18、-0.75和-0.58 mmHg。与IAP相比,IAP显示出小的正偏差(高估),而IAP和IAP显示出负偏差(低估)。进一步的统计分析显示一致性系数为100%,SERENNO系统跟踪IAP变化的能力极佳。与金标准和其他连续技术相比,新型IAP监测设备(SERENNO)的临床前验证显示出非常有前景的结果;然而,作为验证过程的下一阶段应进行临床试验。根据实际研究指南,SERENNO系统可与金标准互换使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bf6/9410406/8edd896199fe/life-12-01161-g001.jpg

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