Effect of bladder volume on measured intravesical pressure a prospective cohort study.docVIP

Available online /content/10/4/R98 Research Open Access Vol 10 No 4 Effect of bladder volume on measured intravesical pressure: a prospective cohort study Manu LNG Malbrain1 and Dries H Deeren2 1Intensive Care Unit, Ziekenhuisnetwerk Antwerpen Campus Stuivenberg, Lange Beeldekensstraat, B-2060 Antwerp, Belgium 2Department of Internal Medicine and Intensive Care Medicine, Ziekenhuisnetwerk Antwerpen Campus Stuivenberg, Lange Beeldekensstraat, B- 2060 Antwerp, Belgium Corresponding author: Manu LNG Malbrain, manu.malbrain@skynet.be Received: 20 Feb 2006 Revisions requested: 13 Mar 2006 Revisions received: 30 Apr 2006 Accepted: 7 Jun 2006 Published: 6 July 2006 Critical Care 2006, 10:R98 (doi:10.1186/cc4962) This article is online at: /content/10/4/R98 ? 2006 Malbrain and Deeren; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction Correct bedside measurement of intra-abdominal pressure (IAP) is important. The bladder method is considered as the gold standard for indirect IAP measurement, but the instillation volumes reported in the literature vary substantially. The aim of this study was to evaluate the effect of instillation volume on intra-bladder pressure (IBP) as an estimation for IAP in critically ill patients. Results In total, 30 measurement sets were performed (mean 2.3 per patient). The median IBP at 25 ml was already significantly higher than IBP at zero volume (7.5 versus 6 mmHg). There was no correlation between IBP at zero volume and absolute IBP bias at any bladder volume. Median absolute IBP bias was 1.5 mmHg at 50 ml; 2.5 mmHg at 100 ml; 5.5 mmHg at 150 ml; and up to 11 mmHg at 300 ml. Methods In this prospective cohort study in 13 sedated and mecha