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Published in: Intensive Care Medicine 3/2005

01-03-2005 | Neonatal and Pediatric Intensive Care

Comparison of indirect methods of measuring intra-abdominal pressure in children

Authors: Peter J. Davis, Satajyit Koottayi, Anna Taylor, Warwick W. Butt

Published in: Intensive Care Medicine | Issue 3/2005

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Abstract

Objective

To determine the most accurate indirect method of measuring intra-abdominal pressure (IAP) in children.

Design and setting

Single-centre, prospective, clinical study in a 23-bed specialist paediatric intensive care unit in Australia.

Patients and participants

20 children admitted to paediatric intensive care with a peritoneal dialysis catheter in situ following congenital cardiac surgery.

Interventions

IAP was measured directly via the peritoneal dialysis catheter and by intragastric manometry via an indwelling nasogastric tube, and by intravesical manometry via an indwelling transurethral urinary catheter, using volumes of 0, 1, 3 and 5 ml/kg body weight of sterile saline instilled into the bladder.

Measurements and results

Across the range of IAPs of 1–8 mmHg the Bland-Altman method for assessing agreement between two methods of clinical measurement showed bladder pressure measured via the urinary catheter with 1 ml/kg body weight of saline instilled to be the most accurate indirect measurement technique, tending to give pressures between 0.07 and 1.23 mmHg higher than the direct measurement (95% CI for bias). Measuring bladder pressure with either no saline instilled or more saline per kilogram body weight instilled was less accurate over the same range of pressures, as was measuring the gastric pressure.

Conclusions

The most accurate indirect method of measuring IAP in children over the normal range of IAPs involves measuring bladder pressure via a transurethral urinary catheter with 1 ml/kg body weight of sterile saline instilled into the bladder.
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Metadata
Title
Comparison of indirect methods of measuring intra-abdominal pressure in children
Authors
Peter J. Davis
Satajyit Koottayi
Anna Taylor
Warwick W. Butt
Publication date
01-03-2005
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 3/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-004-2539-3

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