Does femoral venous pressure measurement correlate well with intrabladder pressure measurement? A multicenter observational trial
De Keulenaer, B. L., Regli, A., Dabrowski, W., Kaloiani, V., Bodnar, Z., Cea, J. I., et al. (2011). Does femoral venous pressure measurement correlate well with intrabladder pressure measurement? A multicenter observational trial. Intensive Care Medicine, 37(10), 1620-1627. doi:10.1007/s00134-011-2298-x
Purpose: 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/m2 was 10.6 ± 4.0 mmHg versus 13.8 ± 3.8 mmHg in patients with a BMI ≥ 30 kg/m2 (P < 0.001).
Conclusions: FVP cannot be used as a surrogate measure of IAP unless IAP is above 20 mmHg.