Document Detail


Rational intraabdominal pressure monitoring: how to do it?
MedLine Citation:
PMID:  17469698     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Intraabdominal hypertension (IAH) is increasingly appreciated by intensivists as an important cause of organ dysfunction, even at pressure levels which were previously thought to be harmless. Therefore, the goal of this review is to describe the different methods commonly used in clinical practice for intraabdominal pressure (IAP) measurement, the advised methodology for each measurement method, and finally to give a rational approach for IAP monitoring in daily clinical practice. METHODS: A Medline search of the English literature was performed using the term "intra abdominal pressure" and "measurement". This resulted in 194 studies, which were then analysed based on the title and abstract. Only clinical studies in human subjects with IAP measurement or related issues as the subject of the study, were considered for inclusion in the study. Reviews, animal experiments and case reports were excluded, while one specific review on IAP measurement and 3 large animal studies (domestic swine > 40 kg) were included in the analysis. This left us with 19 studies, published between 1984 and 2006: 1 specific review, 2 studies in children, 13 in adults and 3 in domestic swine. The references from these studies were searched for relevant articles that may have been missed in the primary search. These articles served as the basis for the recommendations below. RESULTS: Clinical data regarding the validation of new IAP measurement methods or the reliability of established measurement techniques are scarce. The transvesical route, which has been studied most extensively, can be used as reliable route for intermittent IAP measurement, as long as instillation volumes below 25mL are used. Continuous IAP and APP monitoring can be done via a balloon-tipped catheter placed in the stomach or directly intraperitoneal. CONCLUSIONS: Rational IAP monitoring should be based on a site specific protocol, based on known risk factors, the monitoring equipment available and nursing staff experience, and should be linked directly to a local treatment protocol.
Authors:
J J De Waele; I De laet; M L N G Malbrain
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta clinica Belgica. Supplementum     Volume:  -     ISSN:  0567-7386     ISO Abbreviation:  Acta Clin Belg Suppl     Publication Date:  2007  
Date Detail:
Created Date:  2007-05-01     Completed Date:  2007-06-01     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0043523     Medline TA:  Acta Clin Belg Suppl     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  16-25     Citation Subset:  IM    
Affiliation:
Intensive Care Unit, Ghent University Hospital, Gent, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / physiopathology*
Adult
Child
Electrophysiologic Techniques, Cardiac / methods
Humans
Hypertension / physiopathology*,  therapy*
Patient Care / methods*
Practice Guidelines as Topic*
Risk Factors
Severity of Illness Index

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


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