Continuous intra-gastral monitoring of intra-abdominal pressure in critically ill children: a validation study

Abstract Background In critically ill children, detection of intra-abdominal hypertension (IAH > 10 mmHg) and abdominal compartment syndrome (ACS = IAH + organ dysfunction) is paramount usually monitored through intra-vesical pressures (IVP) as current standard. IVP, however, carries important disadvantages, being time-consuming, discontinuous, with infection risk observer-dependent manipulation, ill-defined for catheter sizes. Therefore, we sought to validate air-capsule-based measurement intra-gastric pressure (ACM-IGP). Methods We prospectively compared ACM-IGP IVP both in vivo vitro (water column), according Abdominal-Compartment-Society validation criteria. controlled patient age, admission diagnosis, gastric filling/propulsive medication, respiratory status, sedation levels transurethral catheters, all influencing (IAP). Results tertiary care PICU setting, finally, n 97 children were enrolled (median 1.3 years [range 0 days–17 years], LOS-PICU 8.0 [1–332] days, PRISM-III-Score 13 [0–35]). 2.770 measurements pairs, median IAP was 6.7 [0.9–23.0] mmHg, 38 (39%) suffered from 4 ACS. against water column, correlated perfectly ( r 2 0.99, mean bias ? 0.1 ± 0.5 limits agreement (LOA) 1.1/+ 0.9, percentage error [PE] 12%) 0.98, 0.7 0.6 LOA 0.5/+ 1.9, PE 15%). With larger catheters at higher levels, underestimated column. vivo, between either technique strong 0.95, 0.3 0.8 1.3/+ 1.9 23%). No impact predefined control variables on observed. Conclusions a large population high prevalence, agreed favourably IVP. More widespread usage may improve rates ACS children. Trial registration WHO-ICTRP-No. DRKS00006556 (German Clinical Register). Registered 12th September 2014, URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00006556