The effect of different reference transducer positions measurement on intra-abdominal pressure in ICU patients / 中国实用护理杂志

ABSTRACT

Objective To investigate the effect of different reference transducer positions measurement on intra-abdominal pressure (IAP) in ICU patients. Methods 31 cases of patients in ICU in need of measuring IAP were studied from January 2015 to July 2015 in this study. In each patient, transvesical and the direct methods were both used to measure IAP. Three sets of IAP measurements were obtained in the supine position, using the different reference levels and kept as IAPpubis, IAPmidax, IAPphlebostatic. The results were compared using Spearman rank correlation,paired t test and Bland–Altman statistics. Results When symphysis pubis was uesd, the result of direct method was (9.82±4.01) mmHg, the result of indirect method was (8.77 ± 4.48)mmHg (P<0.05), the correction between two methods was 0.967, P<0.05. When midaxillary level was uesd to measure, the result of direct method was (11.74 ± 4.71) mmHg, the result of indirect method was (11.65 ± 4.63)mmHg, the correction between two methods was 0.972, P=0.10. When phlebostatic was uesd, the result of direct method was (10.98 ± 4.65) mmHg, the result of indirect method was (10.38 ± 4.75)mmHg, the correction between two methods was 0.970, P<0.05. The calculated bias between IAPmidax and IAPpubis was 2.9 mmHg, 95%agreement of limits was (-0.8-6.5) mmHg, and the maximum difference value was 11 mmHg. The calculated bias between IAPmidax and IAPphlebostatic was1.3 mmHg, 95%agreement of limits was-1.4-4.0 mmHg, and the maximum difference value was 4.2 mmHg. Conclusion In supine position, the value obtained via the bladder can reflect the true IAP, and the symphysis pubis or phlebostatic axis reference lines are not interchangeable with the midaxillary level.