Document Detail


Localised abdominal compartment syndrome: bladder-over-gastric pressure ratio (B/G ratio) as a clue to diagnosis.
MedLine Citation:
PMID:  20491359     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have been identified as a cause of organ dysfunction and mortality in critically ill patients. The diagnosis of IAH/ACS depends on accurate intra-abdominal pressure (IAP) measurement, which is usually performed via the bladder or the stomach.The aim of this study was to describe cases where intragastric pressure (IGP) and intrabladder pressure (IBP) were measured simultaneously.
PATIENTS AND METHODS: After review of medical records, four patients admitted to our ICU department where both IGP and IBP were measured, could be identified. IGP was measured using the Spiegelberg catheter and IBP was measured using the FoleyManometer LV. In all patients, the bladder-over-gastric pressure ratio (B/G ratio) was calculated.
RESULTS: In two of four patients, IGP and IBP differed significantly. In one patient the B/G ratio was lower than 1 suggesting a diagnosis of epigastric ACS and in one patient B/G ratio was greater than 1 leading to a diagnosis of pelvic ACS. The latter patient was spared a decompressive laparotomy due to the additional IGP measurement and the subsequent diagnosis of localized ACS.
CONCLUSION: The preferred methods for IAP measurement are via the bladder and via the stomach. In some patients, IGP and IBP may differ significantly and this may have clinical implications. Clinicians should be aware of the possibility of localized ACS. In order to identify risk factors and to recommend treatment for localized ACS, further study of simultaneous IGP and IBP measurements are needed.
Authors:
M L N G Malbrain; I E De Laet; A Willems; N Van Regenmortel; K Schoonheydt; H Dits
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta clinica Belgica     Volume:  65     ISSN:  1784-3286     ISO Abbreviation:  Acta Clin Belg     Publication Date:    2010 Mar-Apr
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-07-22     Revised Date:  2014-03-18    
Medline Journal Info:
Nlm Unique ID:  0370306     Medline TA:  Acta Clin Belg     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  98-106     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Catheterization
Compartment Syndromes / diagnosis*,  etiology,  physiopathology*
Female
Humans
Male
Manometry*
Middle Aged
Pressure
Stomach*
Transducers, Pressure
Urinary Bladder*

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


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