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Measuring Intrabladder Pressure With the Head of the Bed Elevated 30{o}: Evidence to Support a Change in Practice.
MedLine Citation:
PMID:  21724627     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background A 30° head-of-bed elevation is recommended for most critically ill patients. Measuring intrabladder pressure with the patient in this position is controversial. Objective To assess the feasibility of measuring intrabladder pressure with a 30° head-of-bed elevation. Methods A prospective, randomized, and experimental study. Patients had intrabladder pressure measured first while positioned supine with a 30° head-of-bed elevation and 25 mL of saline instilled into the bladder and again after the patients were randomly repositioned to supine without any head-of-bed elevation (flat) or with a 30° head-of-bed elevation while supine or in right lateral or left lateral position with either 25, 50, or 200 mL of saline instilled into the patient's bladder. Results Intrabladder pressures measured with the patient in all 3 head-of-bed elevated positions were higher than pressures measured with patients supine and flat after instillation of 25 mL of saline into the bladder, but intrabladder pressure did not differ between the 30° head-of-bed elevated positions and the supine and flat positions when 50 or 200 mL of saline was instilled into the bladder. Two-way analysis of variance showed a significant interaction between volume of saline instilled (P = .05), patient's position (P = .007), and bladder instill volume and position interaction (P = .004). Conclusion It is feasible to measure intrabladder pressure with a 30° head-of-bed elevation, and that position could be an alternative to supine positioning of patients for measurement of intrabladder pressure.
Authors:
Melanie Horbal Shuster; L Kathleen Sekula; John C Kern; Jorge A Vazquez
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of critical care : an official publication, American Association of Critical-Care Nurses     Volume:  20     ISSN:  1937-710X     ISO Abbreviation:  Am. J. Crit. Care     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-07-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9211547     Medline TA:  Am J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e80-9     Citation Subset:  IM; N    
Affiliation:
Melanie Horbal Shuster is a nutrition clinical nurse specialist and Jorge A. Vazquez is director of medical nutrition at West Penn Allegheny Health System in Pittsburgh, Pennsylvania. L. Kathleen Sekula is an associate professor in the School of Nursing and John C. Kern is an associate professor of statistics in the Department of Mathematics and Computational Science at Duquesne University in Pittsburgh, Pennsylvania.
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