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

Intensive Care Med. 2009 May;35(5):914-8. doi: 10.1007/s00134-008-1376-1. Epub 2009 Jan 6.

Abstract

Objective: To evaluate the efficacy of the urine column (UC) measurement compared to the intra-vesicular pressure (IVP) measurement as an estimation of intra-abdominal 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 end-expiratory. 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.

Publication types

  • Validation Study

MeSH terms

  • Abdomen
  • Body Mass Index
  • Cholecystectomy, Laparoscopic
  • Compartment Syndromes / epidemiology
  • Compartment Syndromes / surgery*
  • Compartment Syndromes / urine*
  • Critical Illness
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pressure*
  • Prospective Studies
  • Reproducibility of Results
  • Sodium Chloride / administration & dosage

Substances

  • Sodium Chloride