Increased intra-abdominal pressure (IAP) is an important vital sign in critically ill patients and has a negative impact on morbidity and mortality. This study aimed to validate a novel non-invasive ultrasonographic approach to IAP measurement against the gold standard intra-bladder pressure (IBP) method. We conducted a prospective observational study in an adult medical ICU of a university hospital. IAP measurements using ultrasonography by two independent operators, with different experience levels (experienced, IAPUS1; inexperienced, IAPUS2), were compared with the gold standard IBP method performed by a third blinded operator. For the ultrasonographic method, decremental external pressure was applied on the anterior abdominal wall using a bottle filled with decreasing volumes of water. Ultrasonography looked at peritoneal rebound upon brisk withdrawal of the external pressure. The loss of peritoneal rebound was identified as the point where IAP was equal to or above the applied external pressure. Twenty-one patients underwent 74 IAP readings (range 2–15 mmHg). The number of readings per patient was 3.5 ± 2.5, and the abdominal wall thickness was 24.6 ± 13.1 mm. Bland and Altman{\textquoteright}s analysis showed a bias (0.39 and 0.61 mmHg) and precision (1.38 and 1.51 mmHg) for the comparison of IAPUS1 and IAPUS2 and vs. IBP, respectively with small limits of agreement that were in line with the research guidelines of the Abdominal Compartment Society (WSACS). Our novel ultrasound-based IAP method displayed good correlation and agreement between IAP and IBP at levels up to 15 mmHg and is an excellent solution for quick decision-making in critically ill patients.
See, KC, Tayebi, S, Sum, CL, Phua, J, Stiens, J, Wise, RD, Mukhopadhyay, A & Malbrain, M 2023, 'Feasibility analysis of a novel non-invasive ultrasonographic method for the measurement of intra-abdominal pressure in the intensive care unit', Journal of Clinical Monitoring and Computing, vol. 37, no. 5, pp. 1351-1359. https://doi.org/10.1007/s10877-023-01024-2
See, K. C., Tayebi, S., Sum, C. L., Phua, J., Stiens, J., Wise, R. D., Mukhopadhyay, A., & Malbrain, M. (2023). Feasibility analysis of a novel non-invasive ultrasonographic method for the measurement of intra-abdominal pressure in the intensive care unit. Journal of Clinical Monitoring and Computing, 37(5), 1351-1359. https://doi.org/10.1007/s10877-023-01024-2
@article{a12ebafa2f444fb88f8bf7f7b2f3ee5e,
title = "Feasibility analysis of a novel non-invasive ultrasonographic method for the measurement of intra-abdominal pressure in the intensive care unit",
abstract = "Increased intra-abdominal pressure (IAP) is an important vital sign in critically ill patients and has a negative impact on morbidity and mortality. This study aimed to validate a novel non-invasive ultrasonographic approach to IAP measurement against the gold standard intra-bladder pressure (IBP) method. We conducted a prospective observational study in an adult medical ICU of a university hospital. IAP measurements using ultrasonography by two independent operators, with different experience levels (experienced, IAPUS1; inexperienced, IAPUS2), were compared with the gold standard IBP method performed by a third blinded operator. For the ultrasonographic method, decremental external pressure was applied on the anterior abdominal wall using a bottle filled with decreasing volumes of water. Ultrasonography looked at peritoneal rebound upon brisk withdrawal of the external pressure. The loss of peritoneal rebound was identified as the point where IAP was equal to or above the applied external pressure. Twenty-one patients underwent 74 IAP readings (range 2–15 mmHg). The number of readings per patient was 3.5 ± 2.5, and the abdominal wall thickness was 24.6 ± 13.1 mm. Bland and Altman{\textquoteright}s analysis showed a bias (0.39 and 0.61 mmHg) and precision (1.38 and 1.51 mmHg) for the comparison of IAPUS1 and IAPUS2 and vs. IBP, respectively with small limits of agreement that were in line with the research guidelines of the Abdominal Compartment Society (WSACS). Our novel ultrasound-based IAP method displayed good correlation and agreement between IAP and IBP at levels up to 15 mmHg and is an excellent solution for quick decision-making in critically ill patients.",
keywords = "Compartment syndrome, · Critical illness, Intensive care unit ·, Intra-abdominal hypertension, Abdominal pressure, Measurement, Bladder pressure, Ultrasonography",
author = "See, {Kay Choong} and Salar Tayebi and Sum, {Chew Lai} and Jason Phua and Johan Stiens and Wise, {Robert Deon} and Amartya Mukhopadhyay and Manu Malbrain",
note = "Funding Information: The authors wish to thank the physicians and nurses of the Medical Intensive Care Unit, National University Hospital, Singapore, for their enthusiasm and support for this study. The authors of the ETRO department acknowledge the “SB Ph.D. fellow at FWO” (“SB-doctoraatsbursaal van het FWO”), Fonds Wetenschappelijk Onderzoek—Vlaanderen, Research Foundation—Flanders, project number: 1S51122N. No other (financial) support was provided. Publisher Copyright: {\textcopyright} 2023, The Author(s), under exclusive licence to Springer Nature B.V. Copyright: Copyright 2023 Elsevier B.V., All rights reserved.",
year = "2023",
month = oct,
doi = "10.1007/s10877-023-01024-2",
language = "English",
volume = "37",
pages = "1351--1359",
journal = "Journal of Clinical Monitoring and Computing",
issn = "1387-1307",
publisher = "Springer Netherlands",
number = "5",
}