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Updated: Jun 8, 2026
Femoral Arterial and Venous Catheterization for Blood Sampling, Drug Administration and Conscious Blood Pressure and Heart Rate Measurements
Published on: January 24, 2012
Intra-abdominal hypertension can be monitored with femoral vein catheters during CRRT and may cause access
1Division of Nephrology, Hypertension and Transplantation, University of Florida, Gainesville, FL, USA.
Insights
Renal replacement therapy machines can accurately measure intra-abdominal pressure (IAH) using built-in sensors. This offers a simpler method for diagnosing IAH in critically ill patients, improving treatment effectiveness.
Area of Science:
- Critical Care Medicine
- Nephrology
- Surgical Physiology
Background:
- Intra-abdominal hypertension (IAH) requires accurate pressure monitoring for diagnosis and management.
- Traditional methods like bladder pressure monitoring are not always feasible.
- Abdominal venous pressure monitoring presents logistical challenges.
Observation:
- Transducers integrated into continuous renal replacement therapy (RRT) devices were tested for pressure monitoring accuracy.
- In vitro testing confirmed high accuracy (r² = 0.998) within the relevant physiological range (0-50 mmHg).
- A clinical protocol was developed and applied to a patient with IAH and femoral vein catheters.
Findings:
- In vitro pressure transducer accuracy was excellent.
- In vivo, RRT device pressure readings correlated perfectly with bladder catheter measurements.
- IAH was associated with access recirculation and reduced RRT effectiveness.
Implications:
- Integrated RRT pressure sensors provide an accurate and accessible method for monitoring intra-abdominal pressure.
- This technique can aid in the early diagnosis and management of IAH in patients undergoing RRT.
- Untreated IAH can significantly impair RRT efficiency and lead to complications like access recirculation.
Objectives:
Intra-abdominal hypertension (IAH) is an increasingly recognized disorder, and its diagnosis depends on accurate pressure monitoring. Bladder-based protocols are favored, but are not always clinically feasible. Abdominal venous (i.e. vena cava) pressure measurements are an alternative but are logistically challenging. We hypothesized that for patients suffering acute kidney injury, transducers built into renal replacement therapy (RRT) machines offer a simple opportunity to monitor pressures using catheters inserted via femoral veins.
Design:
We performed in vitro testing of the accuracy of pressure transducers incorporated into continuous RRT devices, using highly calibrated instrumentation in the IAH-relevant range of 0 to +50 mmHg. We developed a protocol for using this modality in vivo, by stopping all pumps so as to allow equilibration of pressures: clinical application in a patient with femoral vein catheters and IAH was then described.
Results:
In vitro analyses showed accuracy of the extracorporeal pressure transducers with an r² of 0.998, p < 0.001. In the patient case, the pressure transduced at the RRT device was identical to those obtained from bladder catheters. IAH also led to access recirculation and ineffective therapy.
Conclusions:
Pressure sensors incorporated into continuous RRT machines can be accurate in the IAH physiologic range, and thus may be used to easily measure intra-abdominal pressure via appropriate-length femoral vein-inserted access catheters. If not relieved, IAH can be an under-appreciated cause of access recirculation and ineffective clearance for any RRT modality (continuous or intermittent) using femoral catheters.
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