Compartment pressure of the rectus sheath accurately reflects intra-abdominal pressure in a porcine model
Emanuel Benninger, Matthias W Laschke, Markus Cardell, Joerg H Holstein, Burkhardt Seifert, Marius Keel, Otmar Trentz, Michael D Menger & Christoph Meier
abstract
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BACKGROUND
To investigate whether the compartment pressure of the rectus sheath
(CPRS) reflects the intra-abdominal pressure (IAP) under various
conditions of intra-abdominal hypertension (IAH) in a pig model.
METHODS
Design: Prospective experimental study with in vivo pressure
measurements. Setting: Institute for Clinical and Experimental
Surgery, University of Saarland. Animals: Seven domestic male pigs
(body weight 34.8+/-2.5 kg). Interventions: Stepwise increase and
decrease of IAP by means of CO(2) pneumoperitoneum. Continuous
direct measurement of the IAP and correspondent indirect IAP
measurement techniques including analysis of intravesical pressure
(IVP), femoral vein pressure (FVP), and CPRS.
RESULTS
Bland-Altman analysis comparing direct IAP measurement with
correspondent CPRS showed good agreement for IAP between 12 mm Hg
and 30 mm Hg (bias -0.5 mm Hg, lower and upper limits of agreement
(LLA/ULA) -3.5/2.5 mm Hg). FVP (bias -0.3 mm Hg, LLA/ULA -2.3/1.6 mm
Hg) and IVP (bias 0.4 mm Hg, LLA/ULA -2.1/2.9 mm Hg) demonstrated
similar results compared with direct IAP measurement. Agreement was
worse for all indirect IAP measurement techniques for IAP<12 mm
Hg.
CONCLUSIONS
CPRS accurately reflects IAP for IAP> or =12 mm Hg. Accuracy is
similar to established indirect IAP measurement techniques.
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citation
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benninger e, Laschke M W, Cardell M, Holstein J H, Seifert B, Keel
M, Trentz O, Menger M D, Meier C. Compartment pressure of the rectus
sheath accurately reflects intra-abdominal pressure in a porcine
model. J Surg Res 2009; 161:295-300.
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type
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journal paper/review (English)
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date of publishing
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22-10-2009
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journal title
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J Surg Res (161/2)
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ISSN electronic
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1095-8673
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pages
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295-300
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PubMed
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20371081
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DOI
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10.1016/j.jss.2008.11.849
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