A new technique of direct intra-abdominal pressure measurement: A preliminary study

Abstract

Objective The purpose of this study was to determine if a 14-F polyvinyl chloride (PVC) round drain is a reliable tool for direct intra-abdominal pressure measurement. Design A prospective interventional study. Setting Department of Surgery B, intensive care unit, recovery room, Hillel-Yaffe level II trauma center. Methods Forty patients undergoing abdominal surgery and treated postoperatively with intraperitoneal drains and intravesical catheters were included in this study. The indication for insertion of intraperitoneal drains and intravesical catheters was strictly medical. The decision of placing urinary bladder catheter and PVC round drain was done by a senior surgeon. Intra-abdominal pressures were measured simultaneously through the intraperitoneal drain and the urinary catheter. Using a sterile technique, the intraperitoneal drain was disconnected from the drainage bulb and connected to an invasive blood pressure monitoring system. Intravesical pressures were measured by inserting 50 mL into the bladder, and then the urinary catheter was connected to an invasive blood monitoring system. Measurements were done twice a day for 3 days or less if earlier removal of either the intraperitoneal drain or urinary catheters were medically indicated. Results Two hundred twenty-even simultaneous measurements were performed. Pressures as measured through the intraperitoneal drain were found to be significantly correlated to pressures as measured intravesically ( r = 0.962). Conclusions Direct measurement of the intra-abdominal pressure via a 14-F PVC round drain is a newly described technique. Our method is simple, safe, and credible. Future investigation is needed to confirm the reliability of this method for continuous postoperative measurement of the intra-abdominal pressure in selected patients.