Is intra-bladder pressure measurement a reliable indicator for raised intra-abdominal pressure? A prospective comparative study

Abstract

BackgroundIntra-abdominal pressure (IAP) can be measured by several indirect methods; however, the urinary bladder is largely preferred. The aim of this study was to compare intra-bladder pressure (IBP) at different levels of IAPs and assess its reliability as an indirect method for IAP measurement.MethodsWe compared IBP with IAP in twenty-one patients undergoing laparoscopic cholecystectomy under general anesthesia. Measurements were recorded at increasing levels of insufflation pressures to approximately 22 mmHg. Pearson’s correlation coefficient was calculated to establish the relationship between the two pressure measurements and Bland-Altman analysis was used to assess the limits of agreement between the two methods of measurements.ResultsThe urinary bladder pressures reflected well the pressures in the abdominal cavity. Pearson correlation coefficient showed a good correlation between the two measurement techniques (r = 0.966, p < 0.0001) and Bland-Altman analysis indicated that the 95% limits of agreement between the two methods ranged from − 2.83 to 2.64. This range is accepted both clinically and according to the recommendations of the World Society of Abdominal Compartment Syndrome (WSACS).ConclusionOur study showed that IBP measurement is a simple, minimally invasive method that may reliably estimates IAP in patients placed in supine position. Measurements for pressures higher than 12 mmHg may be less reliable. When applied clinically, this should alert the clinician to take safety measures to avoid abdominal compartment syndrome (ACS).

The significance of intra-abdominal pressure in neurosurgery and neurological diseases: a narrative review and a conceptual proposal

“…Values need to be expressed in millimeters of mercury (1 mmHg = 1.36 cmH 2 O). In a prospective comparative study, Al-Abassi et al showed that intra-bladder pressure measurement is a simple, minimally invasive method that may reliably estimate the IAP in patients placed in supine position [ 2 ].…”

Stretchable Capacitive Pressure Sensing Sleeve Deployable onto Catheter Balloons towards Continuous Intra-Abdominal Pressure Monitoring

“…Sustained elevation of IAP > 12 mmHg (1.6 kPa) is termed as intra-abdominal hypertension (IAH), and elevation >20 mmHg (2.7 kPa) is defined as abdominal compartment syndrome (ACS). These IAP elevations can lead to conditions altering organ perfusion and organ dysfunctions [ 1 , 2 ], or even organ failure in extreme cases [ 3 ]. Regular monitoring of IAP aids in the early diagnosis and management of IAH and ACS, which, in turn, has been proven to reduce the rate of morbidity and mortality [ 1 , 2 , 4 ].…”

“…These IAP elevations can lead to conditions altering organ perfusion and organ dysfunctions [ 1 , 2 ], or even organ failure in extreme cases [ 3 ]. Regular monitoring of IAP aids in the early diagnosis and management of IAH and ACS, which, in turn, has been proven to reduce the rate of morbidity and mortality [ 1 , 2 , 4 ]. As recommended by the World Society of the Abdominal Compartment Syndrome (WSACS), IAP measurements are to be made every four hours for critically ill patients.…”

Gastric and Urinary Bladder Pressures Correlate with Intra-abdominal Pressure in Patients with Morbid Obesity

“…A variety of studies sugest to measure frequently IAP in critically il patients. Current practice assesses IAP indirectly through the measurement of intra vesicular pressure, however, only few studies have been performed to establish the actual relationship between IAP and urinary bladder pressure (UBP) [15][16][17] . In obese patients no studies have validated this technique.…”