Abstract
Intra-abdominal hypertension, defined as an intra-abdominal pressure (IAP) equal to or above 12 mmHg is one of the major risk-factors for increased morbidity (organ failure) and mortality in critically ill patients. Therefore, IAP monitoring is highly recommended in intensive care unit (ICU) patients to predict development of abdominal compartment syndrome and to provide a better care for patients hospitalized in the ICU. The IAP measurement through the bladder is the actual reference standard advocated by the abdominal compartment society; however, this measurement technique is cumbersome, non-continuous, and carries a potential risk for urinary tract infections and urethral injury. Using microwave reflectometry has been proposed as one of the most promising IAP measurement alternatives. In this study, a novel radar-based method known as transient radar method (TRM) has been used to monitor the IAP in an in vitro model with an advanced abdominal wall phantom. In the second part of the study, further regression analyses have been done to calibrate the TRM system and measure the absolute value of IAP. A correlation of –0.97 with a p-value of 0.0001 was found between the IAP and the reflection response of the abdominal wall phantom. Additionally, a quadratic relation with a bias of −0.06 mmHg was found between IAP obtained from the TRM technique and the IAP values recorded by a pressure gauge. This study showed a promising future for further developing the TRM technique to use it in clinical monitoring.
Highlights
According to the consensus definitions of the Abdominal Compartment Society (WSACS, formerly known as the World Society of the Abdominal Compartment Syndrome, www.wsacs.org), intra-abdominal pressure (IAP) is defined as the steady-state pressure inside the abdominal cavity [1]
Since intra-abdominal hypertension (IAH) is associated with higher morbidity and mortality, IAP monitoring is highly recommended in intensive care unit (ICU) patients to anticipate and predict the development of abdominal compartment syndrome and to provide a better care for patients hospitalized in the ICU [2]
Several direct and indirect IAP measurement techniques have been proposed in the literature [6,7,8], IAP monitoring through the bladder with a maximal instillation volume of 25 mL of sterile saline is the actual reference standard advocated by the abdominal compartment society [9]
Summary
According to the consensus definitions of the Abdominal Compartment Society (WSACS, formerly known as the World Society of the Abdominal Compartment Syndrome, www.wsacs.org (accessed on: 8 February 2021)), intra-abdominal pressure (IAP) is defined as the steady-state pressure inside the abdominal cavity [1]. Several direct and indirect IAP measurement techniques have been proposed in the literature [6,7,8], IAP monitoring through the bladder with a maximal instillation volume of 25 mL of sterile saline is the actual reference standard advocated by the abdominal compartment society [9] In this method, IAP should be monitored at end-expiration with the patient in supine position. The zero level for the pressure transducer is the mid-axillary line, where it crosses the iliac crest [10] Since this measurement method reflects the pressure inside the bladder, it is not applicable to patients with hematomas or pelvic masses [7]. Using microwave reflectometry has been proposed as one of the most promising IAP measurement methods [8,11]
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