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INTRA ABDOMINAL PRESSURE

MONITORING

Deya Prastika
Product Specialist MS
IDS Medical Systems
Indonesia

FUNG
GROUP

ABVISER

Definition of Terms
Intra-abdominal Pressure (IAP): is the pressure
within the abdominal cavity. Normal IAP is 1 - 8
mmHg.
Intra-abdominal hypertension (IAH): is defined
as an IAP greater than 12mmHg.
Abdominal compartment syndrome (ACS): is
defined as an IAP >20mmHg and the onset of new
organ failure.

Risk factors
Diminished abdominal wall compliance
Major trauma & burns; acute respiratory failure;
abdominal surgery
Increased intra-luminal contents
Gastropareisis; ileus; pseudo obstruction
Increased abdominal contents
oAscites/liver dysfunction;
oHaemoperitioneum/pneumoperitoneum;
Capillary leak/fluid resuscitation
Acidosis (pH<7.2); hypotension;
hypothermia(<33); massive fluid resuscitation;
poly transfusion; coagulopathy; sepsis, major
trauma & burns.

Effect

Procedure for IAP monitoring


Equipment required
Foley urine catheter of appropriate size
Urine bag for drainage of urine
2 x 3 way tap
Connector (leur lock to catheter tip)
Pressure transducer and tubing
50ml leur lock syringe
10ml or 30ml leur lock syringe
Sterile 0.9% sodium chloride
Clamp

Measurement of IAP

Video avalable on youtube : http://www.youtube.com/watch?v=hUU5Yy2iEPM

Special Considerations
0.9% Sodium Chloride should only be used to
fill the patient's bladder when undertaking an
intra abdominal pressure measurement.
The tubing must be free of kinks and air bubbles.
All transducer monitoring lines should be clearly
labeled
Transducer sets should be changed every 72
hours.
All connections should be securely luer locked.
All interventions must be carried out using an
aseptic technique

Complications
Infection of the bladder is a complication of this
procedure. Symptoms vary depending on the age of
the child but include:
Fever
Vomiting
General malaise
Frequency
Local pain
Dysuria

References
Cheatham M, Malbrain M, Kirkpatric A, Sugrue M, Parr M et al (2007). Results from the
international conference of experts on intr-aabdominal hypertension and abdominal compartment
syndrome. II Recommendations. Intensive Care Medicine. 33:951-962.
Davis P, Koottayi S, Taylor A, Butt W. (2005) Comparison of indirect methods of measuring intraabdominal pressure in children. Intensive Care Medicine. 31:471-475
Ejike J, Bahjri K, Mathur M. (2008). What is the normal intra-abdominal pressure in critically ill
children and how should we measure it? Critical Care Medicine. 36(7):2157-2162
Ejike J, Kadry J, Bahjri K, Mathur M. (2010). Semi recumbent position and body mass percentiles:
effects on intra-abdominal pressure measurements in critically ill children.
Gallagher JJ (2000) Ask the Experts Critical Care Nurse, 20, 1 p:87.
Iberti TJ, Lieber CE, Benjamin E. (1989) Determination on intra-abdominal pressure using a
transurethral bladder catheter: clinical validation of the technique. Anesthesiology, 70 (1): 47-50
LCP Rao, CR Chaudhry, LCS Kumar ( 2006) Abdominal Compartment Pressure Monitoring - a
simple techniques. MJAFI,Vol. 62, No. 3.
Moore A, Hargest R, Martin M, Delicata R.J, (2004) Intra-abdominal hypertension and the
abdominal compartment syndrome. British Journal of Surgery, 91: 1102-10
Ravishankar N, Hunter J (2005) Measurement of Intra-abdominal hypertension in intensive care
units in the United Kingdom. British Journal of Anaesthesia Volume 94, Number 6 Pp. 763-766.
Sugrue M, Intra-abdominal pressure: time for clinical practice guidelines?. Intensive Care Med 28:
389-91.
Balough Z, Jones B, Amours S, Parr M and Sugrue M Continuous intra-abdominal pressure
measurement technique. The American Journal of Surgery Volume 188(6):679-684