Saline volume in transvesical intra-abdominal pressure measurement: enough is enough

Waele, Jan De; Pletinckx, Pieter; Blot, Stijn; Hoste, Eric

doi:10.1007/s00134-005-0062-9

Cited by 95 publications

(67 citation statements)

References 15 publications

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“…Because of the potential for activation of the detrusor muscle, several investigators have advocated the use of a minimal volume to ensure conduction of the fluid wave. 30 Our findings indicate that reproducible IBP measurements can be obtained without instilling any sterile saline into the bladder.…”

Section: Recommendations For Volume Of Saline Instilledsupporting

confidence: 54%

Reliability of Intrabladder Pressure Measurement in Intensive Care

Shuster¹,

Haines²,

Sekula³

et al. 2010

American Journal of Critical Care

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BackgroundThe reliability of intrabladder pressure measurements obtained in nonsupine patients is unknown. Objectives To investigate the reliability of measurements of intrabladder pressure obtained with 30° head-of-bed elevation. Methods With patients supine, 30° head-of-bed elevation, and instillation of 0 and 25 mL physiological saline, intrabladder pressure was measured in 10 patients: twice by one nurse to assess intraobserver reliability and once by a different nurse to assess interobserver reliability. Data were analyzed by using paired t tests, Pearson correlation, and Bland-Altman analysis. Results For intraobserver reliability, measurements obtained with no instillation (mean difference, -1.8; 95% confidence interval [CI], -4.9 to 1.3; P = .22) and with instillation of 25 mL (mean difference, -0.6; 95% CI, -1.8 to 0.6; P = .28) did not differ significantly. Pearson r values were 0.74 and 0.81, respectively. Estimated Bland-Altman bias and limits of agreements were -1.8 and -10.3 to 6.7 mm Hg and -0.6 and -3.82 to 2.62 mm Hg, respectively. For interobserver reliability, measurements obtained with no instillation (mean difference, 1.0; 95% CI, -2.2 to 4.2; P = .49) and with instillation of 25 mL (mean difference, -0.7; 95% CI, -2.45 to 1.05; P = .39) did not differ significantly. Pearson r values were 0.78 and 0.82, respectively. Estimated Bland-Altman bias and limits of agreement were 1.0 and -7.76 to 9.76 mm Hg and -0.7 and -5.5 to 4.0 mm Hg, respectively. Conclusions Reliability of intrabladder pressure measurements obtained with 30° head-of-bed elevation is strong. (American Journal of Critical Care. 2010;19:e29-e40

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Section: Recommendations For Volume Of Saline Instilledsupporting

confidence: 54%

Reliability of Intrabladder Pressure Measurement in Intensive Care

Shuster¹,

Haines²,

Sekula³

et al. 2010

American Journal of Critical Care

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“…The instillation volume for intermittent IAP measurement used in different studies varies significantly from 50 to 250 mL. However, De Waele et al revealed that the minimal volume required to transmit the pressure signal was 10 mL (29). Recently, Malbrain and Deeren gradually increasing instillation volumes found that the actual IAP may be overestimated with instillation volumes over 50 mL and the volume up to 25 mL is sufficient (30).…”

Section: Discussionmentioning

confidence: 99%

The influence of fluid balance on intra-abdominal pressure after major abdominal surgery

Šerpytis

Ivaškevičius

2008

Medicina

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“…Our present study protocol was based on these studies. Recently, however, a study was published in which priming with 50 and 100 ml increased the measured IVP compared to 10 ml [20]. Unfortunately, actual IAP was not measured and used as a reference.…”

Section: Discussionmentioning

confidence: 99%

Validation of the urine column measurement as an estimation of the intra-abdominal pressure

et al. 2009

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Objective: To evaluate the efficacy of the urine column (UC) measurement compared to the intravesicular pressure (IVP) measurement as an estimation of intraabdominal pressure (IAP) in patients with IAP up to 30 mmHg. Methods: Fifteen patients undergoing a laparoscopic cholecystectomy were studied. All patients were catheterized. IVP measurements were performed using a pressure transducer connected to the culture aspiration port. UC measurements were done by holding up the tubing against a measuring rod. The symphysis pubis was used as the zero-reference. IAP was raised from 0 to 30 mmHg using increments of 5 mmHg, during which first the IVP and then UC measurement series were recorded endexpiratory. Fifty and 100 ml of saline were used as a priming volume. Results: The IVP and UC measurements showed a significant correlation with IAP. Comparing IVP and UC showed a correlation of 0.91 (p \ 0.001) for 50 ml and 0.87 (p \ 0.001) for 100 ml of saline as a priming volume. Using 50 ml of saline, UC was 0.68 mmHg higher than IVP (95% CI -7.21 to ?5.85 mmHg). For 100 ml of saline, UC was 1.23 mmHg lower than IVP (95% CI -7.41 to ?9.87 mmHg). Conclusion: UC measurement shows significant correlation to IVP measurement as an estimation of the IAP. Further study needs to be done to conclude whether UC measurement is a reliable clinical alternative to IVP measurement.

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Saline volume in transvesical intra-abdominal pressure measurement: enough is enough

Abstract: Using 50 or 100 ml of saline for IAP measurement in critically ill patients results in higher IAP values compared with the use of 10 ml, and possibly, in overestimation of the incidence of intra-abdominal hypertension.

Cited by 95 publications

References 15 publications

Reliability of Intrabladder Pressure Measurement in Intensive Care

Reliability of Intrabladder Pressure Measurement in Intensive Care

The influence of fluid balance on intra-abdominal pressure after major abdominal surgery

Validation of the urine column measurement as an estimation of the intra-abdominal pressure

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