Nursing Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Hepatobiliary and pancreatic surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
PLoS One. 2024 Mar 21;19(3):e0297982. doi: 10.1371/journal.pone.0297982. eCollection 2024.
To provide a comprehensive overview on emerging direct and alternative methods for intra-abdominal pressure (IAP) measurement techniques.
This was a scoping review study following Arksey and Malley's framework. The PubMed, EMBASE, Web of Science, EBSCO, Scopus and ProQuest databases were searched, and we only considered studies published from 2000 as we have extended the data from two previous reviews. Original studies that reported on the development, feasibility and credibility of IAP measurement techniques were included.
Forty-two of 9954 screened articles were included. IAP measurement techniques include three major categories: direct, indirect and less invasive measurement techniques. Agreement analyses were performed in most studies, and some explored the safety, time expenditure and reproducibility of IAP measurement techniques.
Clinical data assessing the validation of new IAP measurement techniques or the reliability of established measurement techniques remain lacking. Considering the cost and invasiveness, direct measurement is not recommended as a routine method for IAP measurement and should be preserved for critically ill patients where standard techniques are contraindicated or could be inaccurate. The measurement accuracy, reliability and sensitivity of the transrectal and transfemoral vein methods remain insufficient and cannot be recommended as surrogate IAP measures. Transvesical measurement is the most widely used method, which is the potentially most easy applicable technique and can be used as a reliable method for continuous and intermittent IAP measurement. Wireless transvaginal method facilitates the quantitative IAP measurement during exercise and activity, which laying the foundations for monitoring IAP outside of the clinic environment, but the accuracy of this technique in measuring absolute IAP cannot be determined at present. Less invasive technology will become a new trend to measure IAP and has substantial potential to replace traditional IAP measurement technologies, but further validation and standardization are still needed. Medical professionals should choose appropriate measurement tools based on the advantages and disadvantages of each IAP technique in combination with assessing specific clinical situations.
提供一种全面的概述，介绍新兴的直接和替代方法用于测量腹腔内压（IAP）的技术。
这是一个遵循 Arksey 和 Malley 框架的范围综述研究。我们检索了 PubMed、EMBASE、Web of Science、EBSCO、Scopus 和 ProQuest 数据库，并仅考虑了自 2000 年以来发表的研究，因为我们已经扩展了之前两项综述的数据。纳入了报告 IAP 测量技术的开发、可行性和可信度的原始研究。
从 9954 篇筛选的文章中，有 42 篇被纳入。IAP 测量技术包括三大类：直接、间接和微创测量技术。大多数研究都进行了一致性分析，有些研究还探讨了 IAP 测量技术的安全性、时间消耗和可重复性。
缺乏评估新 IAP 测量技术的验证或既定测量技术可靠性的临床数据。考虑到成本和侵入性，直接测量不建议作为 IAP 测量的常规方法，而应保留给有创技术禁忌或可能不准确的重症患者。经直肠和股静脉方法的测量准确性、可靠性和敏感性仍然不足，不能作为替代 IAP 测量的方法。经膀胱测量是最广泛使用的方法，它是最具潜在应用价值的技术，可以作为连续和间歇 IAP 测量的可靠方法。无线经阴道测量方法便于在运动和活动期间进行定量 IAP 测量，为在临床环境之外监测 IAP 奠定了基础，但目前无法确定该技术测量绝对 IAP 的准确性。微创技术将成为测量 IAP 的新趋势，具有取代传统 IAP 测量技术的巨大潜力，但仍需要进一步验证和标准化。医疗专业人员应根据每种 IAP 技术的优缺点，并结合具体临床情况，选择合适的测量工具。
