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Abdominal Pressure Measurement

  • Erin Palm
  • Aaron StrumwasserEmail author
Chapter

Abstract

  • Bladder pressure is a safe and minimally invasive method to measure intra-abdominal pressure (IAP) in the critically ill and injured.

  • Normal intra-abdominal pressure is 0 mmHg. In severe obesity and pregnancy, chronically elevated IAP exists at baseline (10–15 mmHg) without adverse sequelae.

  • For most critically ill patients, an IAP of 5–7 mmHg is considered normal.

  • Intra-abdominal pressure of 10–15 mmHg results in decreased visceral organ perfusion.

  • Intra-abdominal Hypertension (IAH) is defined as a sustained pathological elevation in intra-abdominal pressure (IAP) ≥12 mmHg in adults or >10 mmHg in children.

  • Intra-abdominal hypertension severity is graded according to consensus guidelines.
    • Grade I (12–15 mmHg)

    • Grade II (16–20 mmHg)

    • Grade III (20–25 mmHg)

    • Grade IV (above 25 mmHg)

  • Abdominal Compartment Syndrome (ACS) is defined as a sustained elevation in IAP >20 mmHg (>10 mmHg in children) that is associated with new organ dysfunction/failure.

  • Abdominal perfusion pressure (APP): Mean Arterial Pressure (MAP)–IAP is a measure for perfusion of intra-abdominal organs. A target APP associated with appropriate perfusion is >60 mmHg.

  • Abdominal Compartment Syndrome is classified as primary or secondary.
    • Primary ACS is due to a primary intra-abdominal cause such as abdominal trauma, pancreatitis, mesenteric venous obstruction, ascites, and retroperitoneal hemorrhage.

    • Secondary ACS or extra-abdominal syndrome refers to ACS that results from massive bowel edema from sepsis, capillary leak, massive fluid resuscitation, or burns.

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of Southern California, Los Angeles County Medical CenterLos AngelesUSA

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