Document Detail

Harrahill's technique: a simple screening test for intra-abdominal pressure measurement.
MedLine Citation:
PMID:  20490586     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Repair of giant incisional hernias may lead to an increase in intra-abdominal pressure (IAP) and, sometimes, to abdominal compartment syndrome. Measurement of IAP using Kron's technique (Kron et al. in Ann Surg 199:28-30, 1984) is currently accepted as the gold standard, whereas Harrahill has described a simple measurement setup using urinary drainage manometry (Harrahill in J Emerg Nurs 24:465-466, 1998). The aim of this clinical trail was to evaluate the correlation, reproducibility and effectiveness of this device.
METHODS: A prospective cohort study was performed in 43 patients undergoing elective standard abdominal intervention with laparotomy. These patients remain under surveillance in the intensive care unit and require a urinary catheter because of the operation. We performed comparative measurements of IAP using both Korn's (IVM) and Harrahill's (UDM) technique.
RESULTS: Evaluating the correlation between the IVM and UDM techniques, we measured median IAPs of 9.8 +/- 4.1 mmHg (2.9-19.9 mmHg) and 10.0 +/- 4.1 mmHg (min-max: 1.5-19.9 mmHg), respectively. Pearson's coefficient of correlation was r = 0.97. The average of difference between UDM and IVM was -0.2 +/- 0.9 mmHg with limits of agreement of -1.7 to 2.0 mmHg. Evaluating the reproducibility of Harrahill's technique, we found median IAPs of 10.4 +/- 2.1 mmHg (min-max: 2.9-19.1 mmHg) and 10.4 +/- 2.7 mmHg (3.7-19.9 mmHg), respectively, in 43 comparative measurements (Pearson's coefficient of correlation, r = 0.97. The average difference between both measurements was -0.1 +/- 1.1 mmHg with limits of agreement of -2.3 to 2.2 mmHg.
CONCLUSIONS: We were able to demonstrate good correlation and high reproducibility of IAP measurement using Harrahill's technique compared to the gold standard Korn method. We consider this technique as a suitable method for quick and simple screening test for intra-abdominal hypertension, especially after repair of giant incisional hernias.
J Otto; M Binnebösel; K Junge; M Jansen; R Dembinski; V Schumpelick; A Schachtrupp
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article     Date:  2010-05-20
Journal Detail:
Title:  Hernia : the journal of hernias and abdominal wall surgery     Volume:  14     ISSN:  1248-9204     ISO Abbreviation:  Hernia     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-23     Completed Date:  2010-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9715168     Medline TA:  Hernia     Country:  France    
Other Details:
Languages:  eng     Pagination:  415-9     Citation Subset:  IM    
Department of Surgery, University Hospital RWTH, Pauwelsstr. 30, 52074 Aachen, Germany.
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MeSH Terms
Abdominal Cavity
Compartment Syndromes / diagnosis*
Diagnostic Techniques, Digestive System*
Mass Screening
Middle Aged
Prospective Studies
Reproducibility of Results

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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