Saline volume in transvesical intra-abdominal pressure measurement: enough is enough.
OBJECTIVE
The objective was to determine the minimum volume of instillation fluid for intra-abdominal pressure (IAP) measurement, and to evaluate the effect of instillation volume on transvesically measured IAP.


METHODS
Prospective cohort study


METHODS
Twenty-two-bed surgical ICU of the Ghent University Hospital.


METHODS
Twenty patients at risk of intra-abdominal hypertension (IAH).


METHODS
Transvesical IAP measurement using volumes from 10 to 100 ml. Minimal volume at which an IAP was measured was recorded (IAP(min)), as well as IAP at 50 and 100 ml of instillation volume (IAP(50) and IAP(100)). The percentage difference for IAP(50) and IAP(100) was calculated.


RESULTS
The minimal volume for IAP measurement was 10 ml in all patients. Mean IAP(min) was 12.8 mmHg (+/- 4.9), mean IAP(50 )15 mmHg (+/- 4.5) and mean IAP(100) 17.1mmHg (+/- 4.7). The mean percentage difference for IAP(50) was 21% (+/- 17%), and 40% (+/-29%) for IAP(100.) Twelve patients were categorised as suffering from IAH when 10 ml of saline was used for IAP measurement, increasing to 15 and 17 patients respectively when using 50 and 100 ml. In patients with IAH, there was a significant correlation between the duration of bladder drainage and percentage difference for IAP(100) (Pearson correlation coefficient 0.60, p = 0.03).


CONCLUSIONS
Using 50 or 100 ml of saline for IAP measurement in critically ill patients results in higher IAP values compared with the use of 10 ml, and possibly, in overestimation of the incidence of intra-abdominal hypertension.
Ghent University Hospital, Intensive Care Unit 1K12-C, De Pintelaan 185, 9000, Ghent, Belgium. jan.dewaele@UGent.be
J
J
De Waele
P
P
Pletinckx
S
S
Blot
E
E
Hoste
D000005:Abdomen / Q000502:physiology; D000283:Administration, Intravesical; D000368:Aged; D001530:Belgium; D015331:Cohort Studies; D003161:Compartment Syndromes / Q000175:diagnosis* / Q000503:physiopathology; D003422:Critical Care; D016638:Critical Illness; D006801:Humans; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage*
D012965:Sodium Chloride