Skip to main content

Different techniques to measure intra-abdominal pressure (IAP): time for a critical re-appraisal

  • Chapter

Abstract

The diagnosis of intra-abdominal hypertension (IAH) or abdominal compartment syndrome (ACS) is heavily dependant on the reproducibility of the intra-abdominal pressure (IAP) measurement technique. Recent studies have shown that a clinical estimation of IAP by abdominal girth or by examiner’s feel of the tenseness of the abdomen is far from accurate, with a sensitivity of around 40%. Consequently, the IAP needs to be measured with a more accurate, reproducible and reliable tool. The role of the intra-vesical pressure (IVP) as the gold standard for IAP has become a matter of debate. This review will focus on the previously described indirect IAP measurement techniques and will suggest new revised methods of IVP measurement less prone to error. Cost-effective manometry screening techniques will be discussed, as well as some options for the future with microchip transducers.

Keywords

  • Intra-abdominal pressure
  • Intra-abdominal hypertension
  • Abdominal compartment syndrome
  • Intra-vesical pressure

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-642-28233-1_2
  • Chapter length: 15 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   89.00
Price excludes VAT (USA)
  • ISBN: 978-3-642-28233-1
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   119.99
Price excludes VAT (USA)
Hardcover Book
USD   169.99
Price excludes VAT (USA)

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Malbrain MLNG (2001) Intra-abdomi- nal pressure in the Intensive Care Unit: clinical tool or toy? In: Vincent JL (ed) Yearbook of Intensive Care and Emergency Medicine. Springer, Berlin Heidelberg New York, pp 547–585

    Google Scholar 

  2. Malbrain MLNG (2002) Abdominal perfusion pressure as a prognostic marker in intra-abdominal hypertension. In: Vincent JL (ed) Yearbook of Intensive Care and Emergency Medicine. Springer, Berlin Heidelberg New York, pp 792–814

    Google Scholar 

  3. Pouliart N, Huyghens L (2002) An observational study on intraabdominal pressure in 125 critically ill patients. Crit Care 6 (Suppl 1):S3

    CrossRef  Google Scholar 

  4. Malbrain MLNG, for the CIAH study group (2001) Prevalence of intra-ab- dominal hypertension in the ICU. Intensive Care Med 27 (Suppl 2):S176

    Google Scholar 

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

    PubMed  CrossRef  CAS  Google Scholar 

  6. Gudmundsson FF, Viste A, Gislason H, Svanes K (2002) Comparison of different methods for measuring intraabdominal pressure. Intensive Care Med 28:509–514

    PubMed  CrossRef  CAS  Google Scholar 

  7. Verbrugghe W, Van Mieghem N, Daelemans R, Lins R, Malbrain MLNG (2003) Estimating the optimal bladder volume for intra-abdominal pressure measurement by bladder pressure-volume curves. Critical Care 7(Suppl 2):P184

    CrossRef  Google Scholar 

  8. Van Mieghem N, Verbrugghe W, Daelemans R, Lins R, Malbrain MLNG (2003) Can abdominal perimeter be used as an accurate estimation of intraabdominal pressure? Critical Care 7 (Suppl 2):P183

    CrossRef  Google Scholar 

  9. Kirkpatrick AW, Brenneman FD, McLean RF, Rapanos T (2000) Is clinical examination an accurate indicator of raised intra-abdominal pressure in critically injured patients? Can J Surg 43:207–211

    PubMed  CAS  Google Scholar 

  10. Sugrue M, Bauman A, Jones F, Bishop G, Flabouris A, Parr M, Stewart A, Hillman K, Deane SA (2002) Clinical examination is an inaccurate predictor of intraabdominal pressure. World J Surg 26:1428–1431

    PubMed  CrossRef  Google Scholar 

  11. Castillo M, Lis RJ, Ulrich H, Rivera G, Hanf C, Kvetan V (1998) Clinical estimate compared to intra-abdominal pressure measurement. Crit Care Med 26 (Suppl 1):78A

    CrossRef  Google Scholar 

  12. Platell CF, Hall J, Clarke G, Lawrence- Brown (1990) Intra-abdominal pressure and renal function after surgery to the abdominal aorta. Aust N Z J Surg 60:213–216

    PubMed  CrossRef  CAS  Google Scholar 

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

    PubMed  CrossRef  CAS  Google Scholar 

  14. Darovic GO, Vanriper S, Vanriper J (1995) In: Darovic GO (Ed) Hemodynamic monitoring, 2nd edn. WB Saunders, Philadelphia, pp 149–175

    Google Scholar 

  15. Kleinman B, Powell S, Kumar P, Gardner RM (1992) The fast flush test measures the dynamic response of the entire blood pressure monitoring system. Anesthesiology 77:1215–1220

    PubMed  CrossRef  CAS  Google Scholar 

  16. Iberti TJ, Kelly KM, Gentil DR, Hirsch S, Benjamin E (1987) A simple technique to accurately determine intraabdominal pressure. Crit Care Med 15:1140–1142

    PubMed  CrossRef  CAS  Google Scholar 

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

    PubMed  CrossRef  CAS  Google Scholar 

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

    PubMed  CrossRef  CAS  Google Scholar 

  19. Sagraves SG; Cheatham ML; Johnson JL; White M; Block EF; Nelson LD (1997) Intravesicular pressure monitoring does not increase the risk of urinary tract or systemic infection. Crit Care Med 27:A48

    CrossRef  Google Scholar 

  20. Collee GG, Lomax DM, Ferguson C, Hanson GC (1993) Bedside measurement of intra-abdominal pressure (IAP) via an indwelling naso-gastric tube: clinical validation of the technique. Intensive Care Med 19:478–480

    PubMed  CrossRef  CAS  Google Scholar 

  21. Sugrue M, Buist MD, Lee A, Sanchez DJ, Hillman KM (1994) Intra-abdomi- nal pressure measurement using a modified nasogastric tube: description and validation of a new technique. Intensive Care Med 20:588–590

    PubMed  CrossRef  CAS  Google Scholar 

  22. Debaveye Y, Bertieaux S, Malbrain M (2000) Simultaneous measurement of intra-abdominal pressure and regional CO2 via a gastric tonometer. Intensive Care Med 26 (Suppl 3):S324

    Google Scholar 

  23. Malbrain MLNG (2003) Validation of a novel fully automated continuous method to measure intra-abdominal pressure (IAP). Intensive Care Med 29 (Suppl 1):S73

    Google Scholar 

  24. Schachtrupp A, Tons C, Fackeldey V, Hoer J, Reinges M, Schumpelick V (2003) Evaluation of two novel methods for the direct and continuous measurement of intra-abdominal pressure in a porcine model. Intensive Care Med 29:1605–1608

    PubMed  CrossRef  Google Scholar 

  25. Cheatham ML, White MW, Sagraves SG, Johnson JL, Block EFJ (2000) Abdominal perfusion pressure: a superior parameter in the assessment of intra-abdominal hypertension. J Trauma 49:621–627

    PubMed  CrossRef  CAS  Google Scholar 

  26. Harrahill M (1998) Intra-abdominal pressure monitoring. J Emerg Nurs 24:465–466

    PubMed  CrossRef  CAS  Google Scholar 

  27. Lee SL, Anderson JT, Kraut EJ, Wisner DH, Wolfe BM (2002) A simplified approach to the diagnosis of elevated intra-abdominal pressure. J Trauma 52:1169–1172

    PubMed  CrossRef  Google Scholar 

  28. Malbrain MLNG, Leonard M, Delmar- celle D (2002) A novel technique of intra-abdominal pressure measurement: validation of two prototypes. Crit Care 6 (Suppl 1):S2-S3

    CrossRef  Google Scholar 

  29. Lacey SR, Bruce J, Brooks SP, Gris- wald J, Ferguson W, Allen JE, Jewett TC, Karp MP, Cooney DR (1987) The relative merits of various methods of indirect measurement of intra-abdomi- nal pressure as a guide to closure of abdominal wall defects. J Ped Surg 22:1207–1211

    Google Scholar 

  30. Shafik A, El-Sharkawy A, Sharaf WM (1997) Direct measurement of intraabdominal pressure in various conditions. Eur J Surg 163:883–887

    PubMed  CAS  Google Scholar 

  31. Dowdle M (1997) Evaluating a new intrauterine pressure catheter. J Reprod Med 42:506–513

    PubMed  CAS  Google Scholar 

  32. Yol S, Kartal A, Tavli S, Tatkan Y (1998) Is urinary bladder pressure a sensitive indicator of intra-abdominal pressure? Endoscopy 30:778–780

    PubMed  CrossRef  CAS  Google Scholar 

  33. Joynt GM, Gomersall CD, Buckley TA, Oh TE, Young RJ, Freebairn RC (1996) Comparison of intrathoracic and intraabdominal measurements of central venous pressure. Lancet 347:11551157

    CrossRef  Google Scholar 

  34. 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 3:135–138

    PubMed  CrossRef  Google Scholar 

  35. Malbrain MLNG, Van Mieghem BN, Verbrugghe W, Daelemans R, Lins R (2003) Effects of different body positions on intra-abdominal pressure and dynamic respiratory compliance. Crit Care 7 (Suppl 2):P179

    CrossRef  Google Scholar 

  36. Malbrain MLNG (1999) Abdominal pressure in the critically ill: measurement and clinical relevance. Intensive Care Med 25:1453–1458

    PubMed  CrossRef  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Malbrain, M.L.N.G. (2012). Different techniques to measure intra-abdominal pressure (IAP): time for a critical re-appraisal. In: Pinsky, M.R., Brochard, L., Mancebo, J., Antonelli, M. (eds) Applied Physiology in Intensive Care Medicine 2. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-28233-1_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-28233-1_2

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-28232-4

  • Online ISBN: 978-3-642-28233-1

  • eBook Packages: MedicineMedicine (R0)