Journal of Trauma-Injury Infection & Critical Care
Volume 52 - Issue 6 - pp 1169-1172
Abstract
Background: Previous methods described to measure bladder pressure
require additional setup, making these techniques complex and time consuming.
We describe a simple U-tube technique and investigate its accuracy for
measuring intra-abdominal pressure (IAP).
Methods: Warm saline was infused into the peritoneum of five pigs to
increase IAP. Indirect methods of measuring IAP included bladder, inferior vena
cava (IVC), and gastric pressures. Bladder pressure was measured by both the
standard and U-tube technique. IVC pressure was measured via a femoral line and
gastric pressure was transduced through an orogastric tube. In addition, 30
patients undergoing laparoscopy were prospectively investigated. Insufflated
abdominal pressure readings were obtained and compared with bladder pressures
measured by the U-tube technique (n = 20) and standard technique (n = 10).
Results: In the animal study, U-tube manometry had the highest degree
of correlation (r2 = 0.98) and the lowest bias (0.51 ± 1.63 mm Hg). The bladder
pressure measured by the U-tube technique was between 0.1 and 0.9 mm Hg less
than the directly measured IAP (95% confidence interval). There was a high
degree of correlation between IAP and the standard technique for bladder
pressure (r2 = 0.93), IVC pressure (r2 = 0.93), and gastric pressure (r2 =
0.90). Strong correlation also existed between the U-tube and standard
techniques for measuring bladder pressure (r2 = 0.96). In humans, a strong
correlation between insufflated abdominal pressure and bladder pressure (U-tube
technique, r2 = 0.79; standard technique, r2 = 0.53) was also encountered.
Conclusion: The accuracy of the U-tube manometry technique for
measuring intra-abdominal pressure is comparable to previously described
techniques. The U-tube technique is simple, does not require additional
equipment, and can be performed by any member of the medical team.
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