The effect of different reference transducer positions on intra-abdominal pressure measurement

a multicenter analysis

Jan J. De Waele, Inneke De Laet, Bart De Keulenaer, Sandy Widder, Andrew W. Kirkpatrick, Adrian B. Cresswell, Manu Malbrain, Zsolt Bodnar, Jorge H. Mejia-Mantilla, Richard Reis, Michael Parr, Robert Schulze, Sonia Compano, Michael Cheatham

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1299-1303
Number of pages5
JournalIntensive Care Medicine
Volume34
Issue number7
DOIs
Publication statusPublished - 1 Jul 2008
Externally publishedYes

Keywords

  • Abdominal compartment syndrome
  • Critically ill patients
  • Intensive care
  • Intra-abdominal hypertension
  • Intra-abdominal pressure
  • Surgery
  • Trauma

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  • Cite this

    De Waele, J. J., De Laet, I., De Keulenaer, B., Widder, S., Kirkpatrick, A. W., Cresswell, A. B., ... Cheatham, M. (2008). The effect of different reference transducer positions on intra-abdominal pressure measurement: a multicenter analysis. Intensive Care Medicine, 34(7), 1299-1303. https://doi.org/10.1007/s00134-008-1098-4