title: Does femoral venous pressure measurement correlate well with intrabladder pressure measurement? A multicenter observational trial.
abstract: OBJECTIVE
  To investigate if femoral venous pressure (FVP) measurement can be used as a surrogate measure for intra-abdominal pressure (IAP) via the bladder.
  
  
  METHODS
  This was a prospective, multicenter observational study. IAP and FVP were simultaneously measured in 149 patients. The effect of BMI on IAP was investigated.
  
  
  RESULTS
  The incidences of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) were 58 and 7% respectively. The mean APACHE II score was 22 ± 10, SAPS 2 score 42 ± 20, and SOFA score 9 ± 4. The mean IAP was 11.2 ± 4.5 mmHg versus 12.7 ± 4.7 mmHg for FVP. The bias and precision for all measurements were -1.5 and 3.6 mmHg respectively with the lower and upper limits of agreement being -8.6 and 5.7. When IAP was above 20 mmHg, the bias between IAP and FVP was 0.7 with a precision of 2.0 mmHg (lower and upper limits of agreement -3 and 4.6 respectively). Excluding those with ACS, according to the receiver operating curve analysis FVP = 11.5 mmHg predicted IAH with a sensitivity and specificity of 84.8 and 67.0% (AUC of 0.83 (95% CI 0.81-0.86) with P < 0.001). FVP = 14.5 mmHg predicted IAP above 20 mmHg with a sensitivity of 91.3% and specificity of 68.1% (AUC 0.85 (95% CI 0.79-0.91), P < 0.001). Finally, at study entry, the mean IAP in patients with a BMI less then 30 kg/m(2) was 10.6 ± 4.0 mmHg versus 13.8 ± 3.8 mmHg in patients with a BMI ≥ 30 kg/m(2) (P < 0.001).
  
  
  CONCLUSIONS
  FVP cannot be used as a surrogate measure of IAP unless IAP is above 20 mmHg.
authors: Intensive Care Unit, Fremantle Hospital, 1 Alma Street, Fremantle, WA 6160, Australia. bdekeul@hotmail.com
authors: Bart L
authors: BL
authors: De Keulenaer
authors: Adrian
authors: A
authors: Regli
authors: Wojciech
authors: W
authors: Dabrowski
authors: Vaxtang
authors: V
authors: Kaloiani
authors: Zsolt
authors: Z
authors: Bodnar
authors: Javier Izura
authors: JI
authors: Cea
authors: A Andrey
authors: AA
authors: Litvin
authors: Wendy A
authors: WA
authors: Davis
authors: Anne-Marie
authors: AM
authors: Palermo
authors: Jan J
authors: JJ
authors: De Waele
authors: Manu L L N G
authors: ML
authors: Malbrain
mesh_terms: D005260:Female; D005268:Femoral Vein / Q000502:physiology*; D006801:Humans; D059325:Intra-Abdominal Hypertension / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D001743:Urinary Bladder / Q000502:physiology*; D014690:Venous Pressure