Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Intensive Care Medicine
Published in: Intensive Care Medicine 5/2009

Open Access 01-05-2009 | Brief Report

Validation of the urine column measurement as an estimation of the intra-abdominal pressure

Authors: Herjan van der Steeg, Jesse P. van Akkeren, Saskia Houterman, Rudi M. H. Roumen

Published in: Intensive Care Medicine | Issue 5/2009

Login to get access

Abstract

Objective

To evaluate the efficacy of the urine column (UC) measurement compared to the intra-vesicular pressure (IVP) measurement as an estimation of intra-abdominal pressure (IAP) in patients with IAP up to 30 mmHg.

Methods

Fifteen patients undergoing a laparoscopic cholecystectomy were studied. All patients were catheterized. IVP measurements were performed using a pressure transducer connected to the culture aspiration port. UC measurements were done by holding up the tubing against a measuring rod. The symphysis pubis was used as the zero-reference. IAP was raised from 0 to 30 mmHg using increments of 5 mmHg, during which first the IVP and then UC measurement series were recorded end-expiratory. Fifty and 100 ml of saline were used as a priming volume.

Results

The IVP and UC measurements showed a significant correlation with IAP. Comparing IVP and UC showed a correlation of 0.91 (p < 0.001) for 50 ml and 0.87 (p < 0.001) for 100 ml of saline as a priming volume. Using 50 ml of saline, UC was 0.68 mmHg higher than IVP (95% CI −7.21 to +5.85 mmHg). For 100 ml of saline, UC was 1.23 mmHg lower than IVP (95% CI −7.41 to +9.87 mmHg).

Conclusion

UC measurement shows significant correlation to IVP measurement as an estimation of the IAP. Further study needs to be done to conclude whether UC measurement is a reliable clinical alternative to IVP measurement.
Literature
1.
Malbrain ML, Chiumello D, Pelosi P, Wilmer A, Brienza N, Malcangi V, Bihari D, Innes R, Cohen J, Singer P, Japiassu A, Kurtop E, De Keulenaer BL, Daelemans R, Del Turco M, Cosimini P, Ranieri M, Jacquet L, Laterre PF, Gattinoni L (2004) Prevalence of intra-abdominal hypertension in critically ill patients: a multicentre epidemiological study. Intensive Care Med 30:822–829PubMedCrossRef
2.
Cheatham ML, Malbrain 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, Wilmer A (2007) Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. II. Recommendations. Intensive Care Med 33:951–962PubMedCrossRef
3.
Malbrain ML, De Laet I, Cheatham ML (2007) Consensus conference definitions and recommendations on intra-abdominal hypertension (IAH) and the abdominal compartment syndrome (ACS)—the long road to the final publications, how did we get there? Acta Clin Belg Suppl 62:44–59
4.
Cheatham ML, White MW, Sagraves SG, Johnson JL, Block EF (2000) Abdominal perfusion pressure: a superior parameter in the assessment of intra-abdominal hypertension. J Trauma 49:621–627PubMedCrossRef
5.
Ivy ME, Atweh NA, Palmer J, Possenti PP, Pineau M, D’Aiuto M (2000) Intra-abdominal hypertension and abdominal compartment syndrome in burn patients. J Trauma 49:387–391PubMedCrossRef
6.
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 (2006) Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. I. Definitions. Intensive Care Med 32:1722–1732PubMedCrossRef
7.
Malbrain ML (2004) Different techniques to measure intra-abdominal pressure (IAP): time for a critical re-appraisal. Intensive Care Med 30:357–371PubMedCrossRef
8.
Kron IL, Harman PK, Nolan SP (1984) The measurement of intra-abdominal pressure as a criterion for abdominal re-exploration. Ann Surg 199:28–30PubMedCrossRef
9.
Iberti TJ, Lieber CE, Benjamin E (1989) Determination of intra-abdominal pressure using a transurethral bladder catheter: clinical validation of the technique. Anesthesiology 70:47–50PubMedCrossRef
10.
Cheatham ML, Safcsak K (1998) Intra-abdominal pressure: a revised method for measurement. J Am Coll Surg 186:594–595PubMedCrossRef
11.
Harrahill M (1998) Intra-abdominal pressure monitoring. J Emerg Nurse 24:465–466CrossRef
12.
van der Steeg HJJ, Sewing ACP, van Akkeren JP, Roumen RMH (2007) Urine column measurement as an estimation of intra-abdominal pressure: comparison with intra-vesicular pressure measurement as the ‘gold standard’. Acta Clin Belg Suppl 62:285
13.
De Waele JJ, De Laet I, Malbrain ML (2007) Rational intraabdominal pressure monitoring: how to do it? Acta Clin Belg suppl 62:16–25
14.
De Waele JJ, De Laet I, De Keulenaer B, Widder S, Kirkpatrick AW, Cresswell AB, Malbrain M, Bodnar Z, Mejia-Mantilla JH, Reis R, Parr M, Schulze R, Compano S, Cheatham M (2008) The effect of different reference transducer positions on intra-abdominal pressure measurement: a multicenter analysis. Intensive Care Med 34:1299–1303PubMedCrossRef
15.
Chiumello D, Tallarini F, Chierichetti M, Polli F, Li Bassi G, Motta G, Azzari S, Carsenzola C, Gattinoni L (2007) The effect of different volumes and temperatures of saline on the bladder pressure measurement in critically ill patients. Crit Care 11:R82PubMedCrossRef
16.
Verbrugghe W, Van Mieghem N, Daelemans R, Lins R, Malbrain ML (2003) Estimating the optimal bladder volume for intra-abdominal pressure measurement by bladder pressure-volume curves. Crit Care Suppl 7:184CrossRef
17.
Malbrain ML, Deeren DH (2006) Effect of bladder volume on measured intravesicular pressure: a prospective cohort study. Crit Care 10:R98PubMedCrossRef
18.
Fusco MA, Martin RS, Chang MC (2001) Estimation of intra-abdominal pressure by bladder pressure measurement: validity and methodology. J Trauma 50:297–302PubMedCrossRef
19.
Johna S, Taylor E, Brown C, Zimmerman G (1999) Abdominal compartment syndrome: does intra-cystic pressure actual reflect intra-abdominal pressure? A prospective study in surgical patients. Crit Care 3:135–138PubMedCrossRef
20.
De Waele J, Pletinckx P, Blot S, Hoste E (2006) Saline volume intransvesical intra-abdominal pressure measurement: enough is enough. Intensive Care Med 32:455–459PubMedCrossRef
21.
Luca A, Cirera I, Garcia-Pagan JC, Feu F, Pizcueta P, Bosch J, Rodes J (1993) Hemodynamic effects of acute changes in intra-abdominal pressure in patients with cirrhosis. Gastroenterology 104:222–227PubMed
Metadata
Title
Validation of the urine column measurement as an estimation of the intra-abdominal pressure
Authors
Herjan van der Steeg
Jesse P. van Akkeren
Saskia Houterman
Rudi M. H. Roumen
Publication date
01-05-2009
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 5/2009
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-008-1376-1

Other articles of this Issue 5/2009

Intensive Care Medicine 5/2009 Go to the issue

Brief Report

Family members of critically ill cancer patients: assessing the symptoms of anxiety and depression

Original

Serum selenium and glutathione peroxidase-3 activity: biomarkers of systemic inflammation in the critically ill?

Brief Report

Caspofungin for prevention of intra-abdominal candidiasis in high-risk surgical patients

Original

Modeling the effect of time-dependent exposure on intensive care unit mortality

Original

Epidemiology of Mechanical Ventilation: Analysis of the SAPS 3 Database

Editorial

On grief and despair versus resilience and personal growth in critical illness