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DETERMINING NORMAL VALUES FOR INTRA‐ABDOMINAL PRESSURE
Author(s) -
Chionh Joanne J. L.,
Wei Benjamin P. C.,
Martin Jenepher A.,
Opdam Helen I.
Publication year - 2006
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2006.03849.x
Subject(s) - supine position , medicine , urinary bladder , sitting , urinary system , urology , surgery , anesthesia , pathology
Background: Intra‐abdominal pressure (IAP) measurements can be used for the early detection and management of the abdominal compartment syndrome. IAP values are widely thought to be atmospheric or subatmospheric. However, there are no reports that describe normal IAP values using urinary bladder pressure measurements in patients not suspected of having a raised IAP level. This study sought to determine these normal values to aid our interpretation of IAP measurements in post‐surgical patients or patients with suspected increased IAP. Methods: Urinary bladder pressure measurements were carried out in 40 men and 18 women awake medical or non‐abdominal surgery inpatients with existing indwelling catheters. Measurements were made in the supine, 30° and 45° sitting positions. Comparisons were carried out to determine the effects on urinary bladder pressure of body position, sex and a suspected diagnosis of benign prostatic hypertrophy. Results: Median values for IAP were higher if measured in a more upright position ( P < 0.0001). Median values were supine, 9.5 cmH 2 O (range, 1–18 cmH 2 O); 30° upright, 11.5 cmH 2 O (range, 3–19 cmH 2 O); and at 45° upright, 14.0 cmH 2 O (range, 4–22 cmH 2 O). Measurements recorded were neither atmospheric nor subatmospheric. IAP was higher in men compared with women in the supine and 30° positions ( P < 0.05) but not in the 45° position ( P = 0.083). There was no significant difference between patients with and without suspected benign prostatic hypertrophy. Conclusions: Normal IAP using urinary bladder pressure in awake patients are above atmospheric pressure. As a patient is moved from the supine into the upright position, IAP measurements increase.