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Published in: Journal of Clinical Monitoring and Computing 6/2021

01-12-2021 | Original Research

Non-invasive indirect monitoring of intra-abdominal pressure using microwave reflectometry: system design and proof-of-concept clinical trial

Authors: Marcelo David, Aviad Raviv, Ariel Guttel, Valentina García Reyes, Franco Simini, Francisco Pracca

Published in: Journal of Clinical Monitoring and Computing | Issue 6/2021

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Abstract

Monitoring intra-abdominal pressure (IAP) has become a standard in intensive care units. Correlation between the abdominal wall’s thickness (AWTh) and IAP has been reported previously. The abdominal wall can be modeled as a compound of parallel dielectric slabs; changes in their width have a direct effect on the reflection coefficient of the abdominal wall at microwave frequencies. This work describes the design of a reflectometry system and its proof-of-concept trial on five patients during laparoscopic surgery. The system complies with IEEE Std. C95.1-2005 concerning exposure of humans to microwave electromagnetic fields in controlled environments. The results putatively show an inverse correlation between IAP and the reflection coefficient, and a strong dependence on the body mass index. A better understanding of the dynamics in the changes of the AWTh (during intra-abdominal hypertension) will allow further development of a microwave-based technique for the continuous non-invasive indirect monitoring of IAP in critical patients.
Literature
1.
go back to reference De Waele JJ, De Laet I, Kirkpatrick AW, Hoste E. Intra-abdominal hypertension and abdominal compartment syndrome. Am J Kidney Dis. 2011;57(1):159–69.CrossRef De Waele JJ, De Laet I, Kirkpatrick AW, Hoste E. Intra-abdominal hypertension and abdominal compartment syndrome. Am J Kidney Dis. 2011;57(1):159–69.CrossRef
2.
go back to reference Malbrain ML, Cheatham ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, Balogh Z, Leppäniemi A, Olvera C, Ivatury R, D’Amours S, Wendon J, Hillman K, Johansson K, Kolkman K, Wilmer A. Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. I. Definitions. Intensive Care Med. 2006;32(11):1722–32.CrossRef Malbrain ML, Cheatham ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, Balogh Z, Leppäniemi A, Olvera C, Ivatury R, D’Amours S, Wendon J, Hillman K, Johansson K, Kolkman K, Wilmer A. Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. I. Definitions. Intensive Care Med. 2006;32(11):1722–32.CrossRef
3.
go back to reference Sugrue M, Bauman A, Jones F, Bishop G, Flabouris A, Parr M, Stewart A, Hillman K, Deane SA. Clinical examination is an inaccurate predictor of intra-abdominal pressure. World J Surg. 2002;26(12):1428–31.CrossRef Sugrue M, Bauman A, Jones F, Bishop G, Flabouris A, Parr M, Stewart A, Hillman K, Deane SA. Clinical examination is an inaccurate predictor of intra-abdominal pressure. World J Surg. 2002;26(12):1428–31.CrossRef
4.
go back to reference Malbrain ML, Roberts DJ, De Laet I, De Waele JJ, Sugrue M, Schachtrupp A, Duchesne J, Van Ramshorst G, De Keulenaer B, Kirkpatrick AW, Ahmadi-Noorbakhsh S, Mulier J, Ivatury R, Pracca F, Wise R, Pelosi P. The role of abdominal compliance, the neglected parameter in critically ill patients—a consensus review of 16. Part 1: definitions and pathophysiology. Anaesthesiol Intensive Ther. 2014;46(5):392–405.CrossRef Malbrain ML, Roberts DJ, De Laet I, De Waele JJ, Sugrue M, Schachtrupp A, Duchesne J, Van Ramshorst G, De Keulenaer B, Kirkpatrick AW, Ahmadi-Noorbakhsh S, Mulier J, Ivatury R, Pracca F, Wise R, Pelosi P. The role of abdominal compliance, the neglected parameter in critically ill patients—a consensus review of 16. Part 1: definitions and pathophysiology. Anaesthesiol Intensive Ther. 2014;46(5):392–405.CrossRef
5.
go back to reference Malbrain ML, De Laet I, De Waele JJ, Sugrue M, Schachtrupp A, Duchesne J, Van Ramshorst G, De Keulenaer B, Kirkpatrick AW, Ahmadi-Noorbakhsh S, Mulier J, Pelosi P, Ivatury R, Pracca F, David M, Roberts DJ. The role of abdominal compliance, the neglected parameter in critically ill patients—a consensus review of 16. Part 2: measurement techniques and management recommendations. Anaesthesiol Intensive Ther. 2014;46(5):406–32.CrossRef Malbrain ML, De Laet I, De Waele JJ, Sugrue M, Schachtrupp A, Duchesne J, Van Ramshorst G, De Keulenaer B, Kirkpatrick AW, Ahmadi-Noorbakhsh S, Mulier J, Pelosi P, Ivatury R, Pracca F, David M, Roberts DJ. The role of abdominal compliance, the neglected parameter in critically ill patients—a consensus review of 16. Part 2: measurement techniques and management recommendations. Anaesthesiol Intensive Ther. 2014;46(5):406–32.CrossRef
6.
go back to reference Pracca F, Biestro A, Gorrassi J, David M, Simini F, Cancela M. ABDOPRE: an external device for the reduction of intra-abdominal pressure. Preliminary clinical experience. Rev Bras Ter Intensiva. 2011;23:238–41.CrossRef Pracca F, Biestro A, Gorrassi J, David M, Simini F, Cancela M. ABDOPRE: an external device for the reduction of intra-abdominal pressure. Preliminary clinical experience. Rev Bras Ter Intensiva. 2011;23:238–41.CrossRef
7.
go back to reference Malbrain ML. Different techniques to measure intra-abdominal pressure (IAP): time for a critical re-appraisal. In: Applied physiology in intensive care medicine. Berlin: Springer; 2006. p. 105–119. Malbrain ML. Different techniques to measure intra-abdominal pressure (IAP): time for a critical re-appraisal. In: Applied physiology in intensive care medicine. Berlin: Springer; 2006. p. 105–119.
9.
go back to reference Malbrain ML, Chiumello D, Pelosi P, Wilmer A, Brienza N, Malcangi V, Bihari D, Innes R, Cohen J, Singer P, Japiassu A. Prevalence of intra-abdominal hypertension in critically ill patients: a multicentre epidemiological study. Intensive Care Med. 2004;30(5):822–9.CrossRef Malbrain ML, Chiumello D, Pelosi P, Wilmer A, Brienza N, Malcangi V, Bihari D, Innes R, Cohen J, Singer P, Japiassu A. Prevalence of intra-abdominal hypertension in critically ill patients: a multicentre epidemiological study. Intensive Care Med. 2004;30(5):822–9.CrossRef
10.
go back to reference Pracca F, Biestro A, Moraes L, Puppo CB, Calvo SM, Gorrasi J, Cancela M. Direct measurement of intra-abdominal pressure with a solid microtranducer. J Clin Monit Comput. 2007;21(3):167–70.CrossRef Pracca F, Biestro A, Moraes L, Puppo CB, Calvo SM, Gorrasi J, Cancela M. Direct measurement of intra-abdominal pressure with a solid microtranducer. J Clin Monit Comput. 2007;21(3):167–70.CrossRef
11.
go back to reference Iberti TJ, Lieber CE, Benjamin E. Determination of intra-abdominal pressure using a transurethral bladder catheter: clinical validation of the technique. Anesthesiology. 1989;70(1):47–50.CrossRef Iberti TJ, Lieber CE, Benjamin E. Determination of intra-abdominal pressure using a transurethral bladder catheter: clinical validation of the technique. Anesthesiology. 1989;70(1):47–50.CrossRef
12.
go back to reference Cheatham ML, Safcsak K. Intraabdominal pressure: a revised method for measurement. J Am Coll Surg. 1998;186(5):594–5.CrossRef Cheatham ML, Safcsak K. Intraabdominal pressure: a revised method for measurement. J Am Coll Surg. 1998;186(5):594–5.CrossRef
13.
go back to reference David M, Berkovich U, Pracca F. A numerical analysis towards the continuous non-invasive assessment of intra-abdominal pressure in critical patients based on bioimpedance and microwave reflectometry. In: 13th IEEE Biomedical Circuits and Systems Conference, 2017, p. 21–24. https://doi.org/10.1109/BIOCAS.2017.8325053. David M, Berkovich U, Pracca F. A numerical analysis towards the continuous non-invasive assessment of intra-abdominal pressure in critical patients based on bioimpedance and microwave reflectometry. In: 13th IEEE Biomedical Circuits and Systems Conference, 2017, p. 21–24. https://​doi.​org/​10.​1109/​BIOCAS.​2017.​8325053.
14.
go back to reference David M, Raviv A, Peretz A, Berkovich U, Pracca F. Towards a continuous non-invasive assessment of intra-abdominal pressure based on bioimpedance and microwave reflectometry: a pilot run on a porcine model. Biomed Signal Process Control. 2018;44:96–100.CrossRef David M, Raviv A, Peretz A, Berkovich U, Pracca F. Towards a continuous non-invasive assessment of intra-abdominal pressure based on bioimpedance and microwave reflectometry: a pilot run on a porcine model. Biomed Signal Process Control. 2018;44:96–100.CrossRef
15.
go back to reference Grevious MA, Cohen M, Shah SR, Rodriguez P. Structural and functional anatomy of the abdominal wall. Clin Plast Surg. 2006;33(2):169–79.CrossRef Grevious MA, Cohen M, Shah SR, Rodriguez P. Structural and functional anatomy of the abdominal wall. Clin Plast Surg. 2006;33(2):169–79.CrossRef
16.
go back to reference Caix P. Anatomy of the abdominal wall [Article in French]. Ann Chir Plast Esthet. 1999;44(4):289–311.PubMed Caix P. Anatomy of the abdominal wall [Article in French]. Ann Chir Plast Esthet. 1999;44(4):289–311.PubMed
17.
go back to reference Ger R. The clinical anatomy of the anterolateral abdominal wall musculature. Clin Anat. 2009;22(3):392–7.CrossRef Ger R. The clinical anatomy of the anterolateral abdominal wall musculature. Clin Anat. 2009;22(3):392–7.CrossRef
18.
go back to reference Quinn TH, Annibali R, Dalley AF 2nd, Fitzgibbons RJ Jr. Dissection of the anterior abdominal wall and the deep inguinal region from a laparoscopic perspective. Clin Anat. 1995;8(4):245–51.CrossRef Quinn TH, Annibali R, Dalley AF 2nd, Fitzgibbons RJ Jr. Dissection of the anterior abdominal wall and the deep inguinal region from a laparoscopic perspective. Clin Anat. 1995;8(4):245–51.CrossRef
19.
go back to reference Simini F, Bertemes-Filho P. (Eds). Bioimpedance in biomedical applications and research. New York: Springer; 2018. Simini F, Bertemes-Filho P. (Eds). Bioimpedance in biomedical applications and research. New York: Springer; 2018.
20.
go back to reference LH Deng, SH Karagiannoglou, WI Sakkas, JC Barbenel. Effect of geometrical factors of coplanar electrodes on biomedical measurements as exemplified by the electrical impedance measurement of saline and blood. In: Proceeding of the second joint EMBS/BMES conference, 2002, p. 1667–1668. LH Deng, SH Karagiannoglou, WI Sakkas, JC Barbenel. Effect of geometrical factors of coplanar electrodes on biomedical measurements as exemplified by the electrical impedance measurement of saline and blood. In: Proceeding of the second joint EMBS/BMES conference, 2002, p. 1667–1668.
21.
go back to reference Clausen CH, Skands GE, Bertelsen CV, Svendsen WE. Coplanar electrode layout optimized for increased sensitivity for electrical impedance spectroscopy. Micromachines. 2015;6(1):110–20.CrossRef Clausen CH, Skands GE, Bertelsen CV, Svendsen WE. Coplanar electrode layout optimized for increased sensitivity for electrical impedance spectroscopy. Micromachines. 2015;6(1):110–20.CrossRef
22.
go back to reference Yang G, Long H, Tian H, Luo S, Huang H. Bioimpedance measurement: modeling of coplanar electrodes and impedance characterization. In: 2008 2nd International Conference on Bioinformatics and Biomedical Engineering, Shanghai, 2008, p. 1248–1251. Yang G, Long H, Tian H, Luo S, Huang H. Bioimpedance measurement: modeling of coplanar electrodes and impedance characterization. In: 2008 2nd International Conference on Bioinformatics and Biomedical Engineering, Shanghai, 2008, p. 1248–1251.
23.
go back to reference Gabriel S, Lau RW, Gabriel C. The dielectric properties of biological tissues: II. Measurements in the frequency range 10 Hz to 20 GHz. Phys Med Biol. 1996;41(11):2251–69.CrossRef Gabriel S, Lau RW, Gabriel C. The dielectric properties of biological tissues: II. Measurements in the frequency range 10 Hz to 20 GHz. Phys Med Biol. 1996;41(11):2251–69.CrossRef
Metadata
Title
Non-invasive indirect monitoring of intra-abdominal pressure using microwave reflectometry: system design and proof-of-concept clinical trial
Authors
Marcelo David
Aviad Raviv
Ariel Guttel
Valentina García Reyes
Franco Simini
Francisco Pracca
Publication date
01-12-2021
Publisher
Springer Netherlands
Published in
Journal of Clinical Monitoring and Computing / Issue 6/2021
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI
https://doi.org/10.1007/s10877-020-00605-9

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