Alberto Federico García1,2,3, Julián Chica Yantén4,5, Álvaro Ignacio Sánchez4,6, Jose Luis Aldana4,7, Jorge Humberto Mejía4,7, Daniela Burbano5, Camilo Salazar5. 1. Center for Clinical Research (CIC), Fundación Valle del Lili, Carrera 98 No. 18-49, Torre 7, Piso 3 (CIC), Cali, Colombia. alberto.garcia@fvl.org.co. 2. Department of Surgery, Fundación Valle del Lili, Carrera 98 No. 18-49, Cali, Colombia. alberto.garcia@fvl.org.co. 3. School of Medicine, Universidad ICESI, Calle 18 No. 122-135, Cali, Colombia. alberto.garcia@fvl.org.co. 4. Center for Clinical Research (CIC), Fundación Valle del Lili, Carrera 98 No. 18-49, Torre 7, Piso 3 (CIC), Cali, Colombia. 5. School of Medicine, Universidad ICESI, Calle 18 No. 122-135, Cali, Colombia. 6. Department of Surgery, Fundación Valle del Lili, Carrera 98 No. 18-49, Cali, Colombia. 7. Department of Anesthesia, Fundación Valle del Lili, Carrera 98 No. 18-49, Cali, Colombia.
Abstract
BACKGROUND: Abdominal compartment syndrome is a sustained intra-abdominal pressure (IAP) >20 mm Hg associated with new organ dysfunction. In order to prevent its development and related complications, IAP monitoring should be performed in patients with risk factors. Although techniques for its monitoring have been developed, they are of high cost and not always available in low- and lower-middle-income countries. Therefore, we aim to develop and validate in a bench model a handcrafted catheter to be used as an alternative method to measure the intra-gastric pressure (IGP) as a surrogate of the IAP. METHODS: We used an acrylic water container as a model of the abdomen and four handcrafted catheters made of a 16 Fr Levin tube with a globe finger tied with silk in the distal end, inflated with 1 cm of air. They were placed on the bottom of the container where the water pressure was directly measured as a gold standard. The agreement between the two measures was assessed with the Bland-Altman method. RESULTS: We performed 120 simultaneous measures. The mean pressure difference was 0.218 (95% CI 0.074 to 0.363). CONCLUSIONS: The handcrafted prototype catheter and the direct measure were highly correlated. The new catheter is a reliable and reproducible tool for pressure monitoring. However, before it can be used in the clinical setting for IAP monitoring, validation in human models in a real clinical setting needs to be performed.
BACKGROUND:Abdominal compartment syndrome is a sustained intra-abdominal pressure (IAP) >20 mm Hg associated with new organ dysfunction. In order to prevent its development and related complications, IAP monitoring should be performed in patients with risk factors. Although techniques for its monitoring have been developed, they are of high cost and not always available in low- and lower-middle-income countries. Therefore, we aim to develop and validate in a bench model a handcrafted catheter to be used as an alternative method to measure the intra-gastric pressure (IGP) as a surrogate of the IAP. METHODS: We used an acrylic water container as a model of the abdomen and four handcrafted catheters made of a 16 Fr Levin tube with a globe finger tied with silk in the distal end, inflated with 1 cm of air. They were placed on the bottom of the container where the water pressure was directly measured as a gold standard. The agreement between the two measures was assessed with the Bland-Altman method. RESULTS: We performed 120 simultaneous measures. The mean pressure difference was 0.218 (95% CI 0.074 to 0.363). CONCLUSIONS: The handcrafted prototype catheter and the direct measure were highly correlated. The new catheter is a reliable and reproducible tool for pressure monitoring. However, before it can be used in the clinical setting for IAP monitoring, validation in human models in a real clinical setting needs to be performed.
Authors: Michael Sugrue; Adrian Bauman; Felicity Jones; Gillian Bishop; Arthas Flabouris; Michael Parr; Anthony Stewart; Ken Hillman; Stephen A Deane Journal: World J Surg Date: 2002-09-26 Impact factor: 3.352
Authors: Tina Dorn; Manon Ceelen; Koos J C de Keijzer; Marcel C A Buster; Jan S K Luitse; Edwin Vandewalle; Henk J Brouwer; Kees Das Journal: J Forensic Leg Med Date: 2012-05-24 Impact factor: 1.614
Authors: Joost Wauters; Liesbeth Spincemaille; Anne-Sophie Dieudonne; Kenny Van Zwam; Alexander Wilmer; Manu L N G Malbrain Journal: Crit Care Res Pract Date: 2012-02-20
Authors: Andrew W Kirkpatrick; Derek J Roberts; Jan De Waele; Roman Jaeschke; Manu L N G Malbrain; Bart De Keulenaer; Juan Duchesne; Martin Bjorck; Ari Leppaniemi; Janeth C Ejike; Michael Sugrue; Michael Cheatham; Rao Ivatury; Chad G Ball; Annika Reintam Blaser; Adrian Regli; Zsolt J Balogh; Scott D'Amours; Dieter Debergh; Mark Kaplan; Edward Kimball; Claudia Olvera Journal: Intensive Care Med Date: 2013-05-15 Impact factor: 17.440