Indirect intra-abdominal pressure measurement with foley's скачать в хорошем качестве

Indirect intra-abdominal pressure measurement with foley's

WHAT IS ACS? Intra-abdominal hypertension, also known as Abdominal Compartment Syndrome (ACS) is a common and life threatening condition. Variety of methods have been described for measuring intra-abdominal pressure, most of which require complicated procedure and costly equipment, like placing catheter and pressure transducers directly into the abdominal cavity, the stomach, rectum and inferior vena cava. WHAT DID WE DO? We describe a simple and practical method of measuring the intra-abdominal pressure which can be set up easily even in a peripheral hospital and has been validated in experimental and clinical studies (1,2). HOW DOES IT WORK? This technique uses the urinary bladder, an intra-abdominal and extra-peritoneal organ for indirect pressure measurement. The urinary bladder has a compliant wall which acts as a passive reservoir at volumes of less than 100 ml and is capable of transmitting abdominal pressure without imparting any additional pressure from its own musculature. Elevation of head end of bed, adhesions and loculations may give falsely elevated or low measurements. Contraindication for use of this technique is in the patients with preexisting bladder disease and those with bladder trauma. In such case the intra-gastric route can be used (3). HOW CAN I DO IT? Connect foleys to two back to back three way valves. Use one of the three ways to inject normal saline 25-50ml to minimally distend the bladder. Close the valve to urobag and open to manometer (or intravenous set tubing) to measure column height. Column height reflects intra-abdominal pressure. Team of Dr. Amit Dashputra Dr. Shweta Tungal Dr. Akanksha Barnwal Dr. Saurav Vaidya Special thanks to Dr. Sachin Sholapur Under guidance of Dr. A. H. Bhandarwar sir Dr. S. R. Bhagvat sir Dr. Amol Wagh sir Department of General Surgery, Grant Government Medical College, Sir JJ Group of Hospitals, Mumbai Ref: 1. Burch JM, Moore EE, Moore FA, Franciose R. The abdominal compartment syndrome. Surg Clinic of North Am. 1996. 2. Rao P, Chaudhry R, Kumar S. Abdominal compartment pressure monitoring - a simple technique. 2006. 3.Hunter JD, Damani Z. Intra-abdominal hypertension and the abdominal compartment syndrome. Anaesthesia. 2004.