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


CONCLUSIONS
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.
van der Steeg
Herjan
H
Department of Surgery, University Medical Centre St. Radboud, Nijmegen, The Netherlands. h.vandersteeg@chir.umcn.nl
van Akkeren
Jesse P
JP
Houterman
Saskia
S
Roumen
Rudi M H
RM
D000005:Abdomen; D015992:Body Mass Index; D017081:Cholecystectomy, Laparoscopic; D003161:Compartment Syndromes / Q000453:epidemiology / Q000601:surgery* / Q000652:urine*; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D015203:Reproducibility of Results; D012965:Sodium Chloride / Q000008:administration & dosage
D012965:Sodium Chloride