Skip to main content
Log in

Saline volume in transvesical intra-abdominal pressure measurement: enough is enough

  • Brief Report
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript



The objective was to determine the minimum volume of instillation fluid for intra-abdominal pressure (IAP) measurement, and to evaluate the effect of instillation volume on transvesically measured IAP.


Prospective cohort study


Twenty-two-bed surgical ICU of the Ghent University Hospital

Patients and participants

Twenty patients at risk of intra-abdominal hypertension (IAH).


Transvesical IAP measurement using volumes from 10 to 100 ml. Minimal volume at which an IAP was measured was recorded (IAPmin), as well as IAP at 50 and 100 ml of instillation volume (IAP50 and IAP100). The percentage difference for IAP50 and IAP100 was calculated.

Measurements and results

The minimal volume for IAP measurement was 10 ml in all patients. Mean IAPmin was 12.8 mmHg (± 4.9), mean IAP50 15 mmHg (± 4.5) and mean IAP100 17.1mmHg (± 4.7). The mean percentage difference for IAP50 was 21% (± 17%), and 40% (± 29%) for IAP100.

Twelve patients were categorised as suffering from IAH when 10 ml of saline was used for IAP measurement, increasing to 15 and 17 patients respectively when using 50 and 100 ml.

In patients with IAH, there was a significant correlation between the duration of bladder drainage and percentage difference for IAP100 (Pearson correlation coefficient 0.60, p = 0.03).


Using 50 or 100 ml of saline for IAP measurement in critically ill patients results in higher IAP values compared with the use of 10 ml, and possibly, in overestimation of the incidence of intra-abdominal hypertension.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2


  1. Malbrain ML (2004) Is it wise not to think about intraabdominal hypertension in the ICU? Curr Opin Crit Care 10:132–145

    Article  PubMed  Google Scholar 

  2. Malbrain ML, Chiumello D, Pelosi P, Wilmer A, Brienza N, Malcangi V, Bihari D, Innes R, Cohen J, Singer P, Japiassu A, Kurtop E, De Keulenaer BL, Daelemans R, Del Turco M, Cosimini P, Ranieri M, Jacquet L, Laterre PF, Gattinoni L (2004) Prevalence of intra-abdominal hypertension in critically ill patients: a multicentre epidemiological study. Intensive Care Med 30:822–829

    Article  PubMed  Google Scholar 

  3. Kron IL, Harman PK, Nolan SP (1984) The measurement of intra-abdominal pressure as a criterion for abdominal re-exploration. Ann Surg 199:28–30

    Article  PubMed  CAS  Google Scholar 

  4. Fusco MA, Martin RS, Chang MC (2001) Estimation of intra-abdominal pressure by bladder pressure measurement: validity and methodology. J Trauma 50:297–302

    Article  PubMed  CAS  Google Scholar 

  5. Johna S (2001) Can we use the bladder to estimate intra-abdominal pressure? J Trauma 51:1218

    PubMed  CAS  Google Scholar 

  6. Malbrain ML (2004) Different techniques to measure intra-abdominal pressure (IAP): time for a critical re-appraisal. Intensive Care Med 30:357–371

    Article  PubMed  Google Scholar 

  7. Cheatham ML, Safcsak K (1998) Intraabdominal pressure: a revised method for measurement. J Am Coll Surg 186:594–595

    Article  PubMed  CAS  Google Scholar 

  8. Hackler RH, Hall MK, Zampieri TA (1989) Bladder hypocompliance in the spinal cord injury population. J Urol 141:1390–1393

    PubMed  CAS  Google Scholar 

  9. Johna S, Taylor E, Brown C, Zimmerman G (1999) Abdominal compartment syndrome: does intra-cystic pressure reflect actual intra-abdominal pressure? A prospective study in surgical patients. Crit Care (Lond) 3:135–138

    Article  Google Scholar 

  10. Iberti TJ, Lieber CE, Benjamin E (1989) Determination of intra-abdominal pressure using a transurethral bladder catheter: clinical validation of the technique. Anesthesiology 70:47–50

    Article  PubMed  CAS  Google Scholar 

  11. Balogh Z, Jones F, D'Amours S, Parr M, Sugrue M (2004) Continuous intra-abdominal pressure measurement technique. Am J Surg 188:679–684

    Article  PubMed  Google Scholar 

  12. Lonardo M, Piazza O (2005) Incidence of intraabdominal hypertension in the intensive care unit. Crit Care Med 33:2150

    Article  PubMed  Google Scholar 

  13. Burch JM, Moore EE, Moore FA, Franciose R (1996) The abdominal compartment syndrome. Surg Clin North Am 76:833–842

    Article  PubMed  CAS  Google Scholar 

  14. Cheatham ML, White MW, Sagraves SG, Johnson JL, Block EF (2000) Abdominal perfusion pressure: a superior parameter in the assessment of intra-abdominal hypertension. J Trauma 49:621–626

    PubMed  CAS  Google Scholar 

Download references


Jan J. De Waele is supported by a Clinical Doctoral Grant from the Fund for Scientific Research — Flanders (Belgium; F.W.O. – Vlaanderen).

Author information

Authors and Affiliations


Corresponding author

Correspondence to J. De Waele.

Additional information

This work was presented at the annual meeting of the European Society of Intensive Care Medicine, Amsterdam 10–13 October 2005

Rights and permissions

Reprints and permissions

About this article

Cite this article

De Waele, J., Pletinckx, P., Blot, S. et al. Saline volume in transvesical intra-abdominal pressure measurement: enough is enough. Intensive Care Med 32, 455–459 (2006).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: