TY - JOUR
T1 - The effect of different reference transducer positions on intra-abdominal pressure measurement
T2 - a multicenter analysis
AU - De Waele, Jan J.
AU - De Laet, Inneke
AU - De Keulenaer, Bart
AU - Widder, Sandy
AU - Kirkpatrick, Andrew W.
AU - Cresswell, Adrian B.
AU - Malbrain, Manu
AU - Bodnar, Zsolt
AU - Mejia-Mantilla, Jorge H.
AU - Reis, Richard
AU - Parr, Michael
AU - Schulze, Robert
AU - Compano, Sonia
AU - Cheatham, Michael
PY - 2008/7/1
Y1 - 2008/7/1
N2 - Objective: To investigate the effect of different reference transducer positions on intra-abdominal pressure (IAP) measurement. Three reference levels were studied: the symphysis pubis; the phlebostatic axis; and the midaxillary line at the level of the iliac crest. Design: Prospective cohort study. Setting: The intensive care units of participating hospitals Patients and participants: One hundred thirty-two critically ill patients at risk for intra-abdominal hypertension (IAH). Interventions: In each patient, three sets of IAP measurements were obtained in the supine position, using the different reference levels. The IAP measurements obtained at the different reference levels were compared using a paired t-test and Bland-Altman statistics were calculated. Measurements and results: IAPphlebostatic (9.9 ± 4.67 mmHg) and IAPpubis (8.4 ± 4.60 mmHg) were significantly lower that IAPmidax (12.2 ± 4.66 mmHg; p < 0.0001 for both comparisons). The bias between the IAPmidax and IAPpubis was 3.8 mmHg (95% CI 3.5-4.1) and 2.3 mmHg (95% CI 1.9-2.6) between the IAP midax and the IAPphlebostatic. The precision was 3.03 and 3.40, respectively. Conclusions: In the supine position, IAPmidax is higher than both IAPphlebostatic and IAPpubis, differences found to be clinically significant; therefore, the symphysis pubis or phlebostatic axis reference lines are not interchangeable with the midaxillary level.
AB - Objective: To investigate the effect of different reference transducer positions on intra-abdominal pressure (IAP) measurement. Three reference levels were studied: the symphysis pubis; the phlebostatic axis; and the midaxillary line at the level of the iliac crest. Design: Prospective cohort study. Setting: The intensive care units of participating hospitals Patients and participants: One hundred thirty-two critically ill patients at risk for intra-abdominal hypertension (IAH). Interventions: In each patient, three sets of IAP measurements were obtained in the supine position, using the different reference levels. The IAP measurements obtained at the different reference levels were compared using a paired t-test and Bland-Altman statistics were calculated. Measurements and results: IAPphlebostatic (9.9 ± 4.67 mmHg) and IAPpubis (8.4 ± 4.60 mmHg) were significantly lower that IAPmidax (12.2 ± 4.66 mmHg; p < 0.0001 for both comparisons). The bias between the IAPmidax and IAPpubis was 3.8 mmHg (95% CI 3.5-4.1) and 2.3 mmHg (95% CI 1.9-2.6) between the IAP midax and the IAPphlebostatic. The precision was 3.03 and 3.40, respectively. Conclusions: In the supine position, IAPmidax is higher than both IAPphlebostatic and IAPpubis, differences found to be clinically significant; therefore, the symphysis pubis or phlebostatic axis reference lines are not interchangeable with the midaxillary level.
KW - Abdominal compartment syndrome
KW - Critically ill patients
KW - Intensive care
KW - Intra-abdominal hypertension
KW - Intra-abdominal pressure
KW - Surgery
KW - Trauma
UR - http://www.scopus.com/inward/record.url?scp=46149126428&partnerID=8YFLogxK
U2 - 10.1007/s00134-008-1098-4
DO - 10.1007/s00134-008-1098-4
M3 - Article
C2 - 18389215
AN - SCOPUS:46149126428
SN - 0342-4642
VL - 34
SP - 1299
EP - 1303
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 7
ER -