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Evaluation of a modified piezoresistive technique and a water-capsule technique for direct and continuous measurement of intra-abdominal pressure in a porcine model.

Abstract：

OBJECTIVE:Intravesical pressure measurement is considered to be the gold standard for the assessment of intra-abdominal pressure. However, this method is indirect and depends on a physiologic bladder function. We evaluated a modified piezoresistive technique and a water-capsule technique for direct and continuous intra-abdominal pressure measurement. DESIGN:Experimental study. SETTING:Animal research laboratory. SUBJECTS:Eleven male domestic pigs. INTERVENTIONS:In anesthetized and mechanically ventilated animals, CO2 was insufflated to stepwise increase the intra-abdominal pressure to 30 mm Hg. Pressure was then held constant for 9 hrs followed by decompression. Piezoresistive measurement and water-capsule measurement probes were placed intra-abdominally. MEASUREMENTS AND MAIN RESULTS:Readings of intravesical pressure measurement, piezoresistive measurement, and water-capsule measurement were taken hourly. Mean difference to insufflator readings, confidence intervals, and limits of agreement were calculated. Differences between applied pressure and intra-abdominal pressure readings were assessed using a two-factor analysis of variance. No significant differences between methods could be observed. During stepwise pressure increase, limits of agreements were -3.6 to 3.6 mm Hg. Confidence intervals were -3.4 to 3.5 (intravesical pressure measurement), -1.6 to 1.5 (piezoresistive measurement), and 0.5 to 2.9 mm Hg (water-capsule measurement). In the presence of constantly elevated intra-abdominal pressure, limits of agreement ranged from -8.2 to +8.2 mm Hg. Confidence intervals were -0.4 to 6.2 (intravesical pressure measurement), -0.2 to 2.7 (piezoresistive measurement), and 1.1 to 5.1 mm Hg (water-capsule measurement). CONCLUSIONS:Both piezoresistive measurement and water-capsule measurement had smaller confidence intervals than intravesical pressure measurement, indicating higher precision, whereas water-capsule measurement had a significant offset. Piezoresistive measurement could be the most suitable device for continuous direct intra-abdominal pressure monitoring in specific patients.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Schachtrupp A,Henzler D,Orfao S,Schaefer W,Schwab R,Becker P,Schumpelick V

doi

10.1097/01.CCM.0000198526.04530.36

subject

Has Abstract

pub_date

2006-03-01 00:00:00

pages

745-50

issue

eissn

0090-3493

issn

1530-0293

pii

00003246-200603000-00024

journal_volume

pub_type

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Evaluation of a modified piezoresistive technique and a water-capsule technique for direct and continuous measurement of intra-abdominal pressure in a porcine model.