Reliability of Intrabladder Pressure Measurement in Intensive Care

Shuster, Melanie Horbal; Haines, Tammy; Sekula, L. Kathleen; Kern, John C.; Vazquez, Jorge A.

doi:10.4037/ajcc2010204

Cited by 14 publications

(8 citation statements)

References 39 publications

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“…Put another way, differences greater than this amount should suggest true changes in (patho‐) physiology. Furthermore, esophageal manometry seems as robust as other commonly used intensive care unit (ICU) parameters, such as pulmonary artery catheter and bladder measurements of intra‐abdominal pressure (26). In terms of clinical use in the ICU, our data provide guidance for ICU practitioners as to a normal value of P Es in subjects with mild to moderate obesity.…”

Section: Discussionmentioning

confidence: 99%

Sitting and Supine Esophageal Pressures in Overweight and Obese Subjects

Owens¹,

Campana²,

Hess³

et al. 2012

Obesity

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Esophageal pressure can be used to approximate pleural pressure and might be clinically useful, particularly in the obese e.g to guide mechanical ventilator settings in critical illness. However, mediastinal artifact (the difference between true pleural pressure and esophageal pressure) may limit acceptance of the measurement, and reproducibility of esophageal pressure measurements remains unknown. Therefore, we aimed to assess the effect of body posture on esophageal pressure in a cohort of obese but healthy subjects, some of whom had multiple measurements, to address the clinical robustness of esophageal manometry. Twenty-five overweight and obese subjects (BMI>25kg/m2) and 11 control lean subjects (BMI<25kg/m2) underwent esophageal manometry with pressures measured seated and supine. Twenty overweight and obese subjects had measurements repeated after ~1-2 weeks. Anthropometric data and sitting and supine spirometry were recorded. The average end-expiratory esophageal pressures sitting and supine were greater in the overweight and obese group than the lean group (sitting −0.1±2.1 vs. −3.3±1.2cmH2O, supine 9.3±3.3 vs. 6.9±2.8cmH2O, respectively). The mean differences between repeated measurements were small (−0.3 ± 1.7cmH2O sitting and −0.1 ± 1.5cmH2O supine). Esophageal pressures correlated with a number of anthropometric and spirometric variables. In conclusion, esophageal pressures are slightly greater in overweight and obese subjects than lean subjects; but changes with position are similar in both groups. These data indicate that mediastinal weight and postural effects on esophageal pressure are within a clinically acceptable range, and suggest that esophageal manometry can be used to inform clinical decision making across wide range of body types.

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Section: Discussionmentioning

confidence: 99%

Sitting and Supine Esophageal Pressures in Overweight and Obese Subjects

Owens¹,

Campana²,

Hess³

et al. 2012

Obesity

View full text Add to dashboard Cite

show abstract

“…This finding emphasizes the importance of establishing a trend rather then relying on a single measurement to make important management decisions. Studies have shown low inter‐ and intraobserver variability with use of the IVP method in people and critically ill dogs . In cats, no significant differences in measurements were obtained between the observers in a study of healthy cats using the IVP technique utilizing a water manometer …”

Section: Factors Affecting Iapmentioning

confidence: 97%

“…Vital to the understanding of IAH and ACS is the appreciation of the factors that may influence IAP readings, their reproducibility, and their dependability . In the past several years, as techniques for IAP measurement have evolved, multiple pitfalls have come to light and thus work has been done in the attempt to identify and eliminate many of these limitations . If a patient is incorrectly labeled as having IAH or ACS, interventions taken to reduce the pressure may subject the patient to increased morbidity, either from the intervention itself or from a delay in proper treatment for comorbid disease.…”

Section: Factors Affecting Iapmentioning

confidence: 99%

Measurement of intra‐abdominal pressure in dogs and cats

Smith¹,

Sande²

2012

J Vet Emergen Crit Care

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“…The end of the catheter was connected to clear, open-ended plastic tubing, and the level of the water column above the midaxillary line reflects IAP. [13] IAP is measured for the patients in various body positions; the supine (HOB-0, HOB-15, and HOB-30) followed by right lateral (HOB-0, HOB-15, and HOB-30), at least 4 hours apart over a 24-h period. Intra-abdominal hypertension is graded into four categories; Grade I: IAP 12-15 mmHg, Grade II: IAP 16-20 mmHg, Grade III: IAP 21-25 mmHg, and Grade IV: IAP > 25 mmHg.…”

Section: Interventionmentioning

confidence: 99%

The effect of reference position versus right lateral position on the intra-abdominal pressure in mechanically ventilated patients

Mahran¹,

Abd‐Elshafy²,

Neem³

et al. 2018

JNEP

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Background and objective: Intra-abdominal hypertension (IAH) is a frequent plentiful problem in patients admitted to critical care units. It ranges from a surge incidence of morbidity and mortality to a particular need for nursing health care, so recognition of the occurrence of IAH is a very critical issue for critical care nurses and physician. This study aimed to recognize the effects of various body position with the various head of bed elevation on the intra-abdominal pressure (IAP) in patients with mechanical ventilation. Methods: Design: A non-randomized, prospective observational study was used. Setting: Trauma and general intensive care units at Assuit University Hospitals. Method: In a prospective observational study, during the third day of mechanical ventilation, 60 patients were screened for IAP via a urinary catheter, in two various body positions in three separate degrees of the head of the bed (HOB) elevation (0 • , 15• , and 30 • ). The position was changed at least 4 hours apart over a 24-h period.Results: In lateral recumbence, IAP measurements were significantly elevated compared to supine position, they were 19.70 ± 3.09 mmHg versus 16.00 ± 3.14 (p < .001), 22.80 ± 3.56 mmHg versus 19.03 ± 2.95 (p < .001), and 26.08 ± 3.59 mmHg versus 21.46 ± 2.90 versus (p < .001) at 0 • , 15• , and 30• respectively. The mean of IAP difference was 3.7 ± 3.0 mmHg at 0 • , 3.8 ± 1.00 mmHg at 15• , and 5.5 ± 1.01 mmHg at 30 • (p < .005).Conclusions: IAP reading is significantly elevated by changing from supine to lateral position especially with HOB elevation and significantly correlated with mortality rate in patients with mechanical ventilation

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Reliability of Intrabladder Pressure Measurement in Intensive Care

Cited by 14 publications

References 39 publications

Sitting and Supine Esophageal Pressures in Overweight and Obese Subjects

Sitting and Supine Esophageal Pressures in Overweight and Obese Subjects

Measurement of intra‐abdominal pressure in dogs and cats

The effect of reference position versus right lateral position on the intra-abdominal pressure in mechanically ventilated patients

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