01-05-2009 | Physiological and Technical Notes
Comparison of a new device for the continuous intra-gastric measurement of intra-abdominal pressure (CiMon) with direct intra-peritoneal measurements in cirrhotic patients during paracentesis
Published in: Intensive Care Medicine | Issue 5/2009
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Objective
To evaluate a new commercially available system for the intra-gastric measurement of intra-abdominal pressure (IAP).
Design and setting
Prospective interventional trial in an intensive care unit of a university hospital.
Patients
Ten patients with cirrhosis and tense ascites scheduled for paracentesis and instrumented with a ballon-tipped nasogastric tube.
Intervention
Intermittent paracentesis with repeat paired measurements of IAP.
Measurements and results
Intra-abdominal pressure was measured directly through the paracentesis catheter using a scaled measurement gauge. Simultaneously, intra-gastric measurements were performed with the CiMon device (Pulsion Medical Systems, Munich, Germany), by means of a ballon-tipped nasogastric tube connected to a pressure transducer. The range of IAP was 6.5–28 mmHg for direct measurements and 3.7–16 mmHg for measurements obtained with the CiMon device. The regression equation according to Passing and Bablok for the two methods had an intercept of 0.054 (95% CI–1.475–1.669) and a slope of 0.674 (95% CI 0.538–0.813). The cusum test showed a significant deviation from linearity (P < 0.05). In the Bland–Altman test bias and limits of agreement were – 4.9 (±6.8) mmHg or, expressed as percentage of the average, −44% (±49%).
Conclusion
Intra-gastric measurments of IAP using the CiMon device were not reliable enough to be clinically useful in these ascitic patients.