Comparison of a new device for the continuous intra-gastric measurement of intra-abdominal pressure (CiMon) with direct intra-peritoneal measurements in cirrhotic patients during paracentesis.
OBJECTIVE
To evaluate a new commercially available system for the intra-gastric measurement of intra-abdominal pressure (IAP).


METHODS
Prospective interventional trial in an intensive care unit of a university hospital.


METHODS
Ten patients with cirrhosis and tense ascites scheduled for paracentesis and instrumented with a ballon-tipped nasogastric tube.


METHODS
Intermittent paracentesis with repeat paired measurements of IAP.


RESULTS
Intra-abdominal pressure was measured directly through the paracentesis catheter using a scaled measurement gauge. Simultaneously, intra-gastric measurements were performed with the CiMon device (Pulsion Medical Systems, Munich, Germany), by means of a ballon-tipped nasogastric tube connected to a pressure transducer. The range of IAP was 6.5-28 mmHg for direct measurements and 3.7-16 mmHg for measurements obtained with the CiMon device. The regression equation according to Passing and Bablok for the two methods had an intercept of 0.054 (95% CI-1.475-1.669) and a slope of 0.674 (95% CI 0.538-0.813). The cusum test showed a significant deviation from linearity (P < 0.05). In the Bland-Altman test bias and limits of agreement were - 4.9 (+/-6.8) mmHg or, expressed as percentage of the average, -44% (+/-49%).


CONCLUSIONS
Intra-gastric measurements of IAP using the CiMon device were not reliable enough to be clinically useful in these ascitic patients.
Becker
Valentin
V
II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675 Munich, Germany.
Schmid
Roland M
RM
Umgelter
Andreas
A
D000005:Abdomen; D000368:Aged; D001201:Ascites / Q000453:epidemiology; D015992:Body Mass Index; D003161:Compartment Syndromes / Q000175:diagnosis* / Q000601:surgery; D016638:Critical Illness; D005260:Female; D005355:Fibrosis / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008365:Manometry; D008875:Middle Aged; D019152:Paracentesis / Q000379:methods*; D011312:Pressure; D011446:Prospective Studies