| Abstract: Introduction: Increased intra-abdominal pressure (IAP) is well known as a source of morbidity and mortality following laparotomy. To assess intra-abdominal pressure a variety of methods have been described. Indirect bladder pressure has been accepted as the golden standard.
Objective: To investigate prospectively the association between the bladder pressure and direct intra-abdominal pressure measured by a single lumen central venous catheterization set (Arrow international). Furthermore the association between speed of IAP increase and the development of an intra-abdominal compartment syndrome was established.
Methods: In total 23 patients, mean age 72.4 +/- 6.6, were included. All patients received a laparotomy for an aneurysm and were followed on the intensive care unit for at least two days. Both bladder pressure and standardized direct intra-abdominal pressure were assessed at the same time and at least four times a day. In total 217 measurements were performed.
Results: Mean IAP measured by bladder pressure and the single lumen intra-abdominal catheter was respectively, 13.4 +/- 6.2 mmHg and 11.1 +/- 5.8mmHg (p<.001). There was a high degree of correlation between IAP measured by bladder pressure and the single lumen catheter r2=0,82 en p<.001. Four patients (17%) developed an intra-abdominal compartment syndrome (pressure >30mmHg in combination with renal and respiratory dysfunction), followed by decompression laparotomy. An increase of the intra-abdominal pressure 5 mmHg per hour, seemed to be a predictor for development of an intra-abdominal compartment syndrome.
Conclusions: Direct measurement of the intra-abdominal pressure by a single lumen central venous catheterization set is a reliable method. Assessment by a single lumen catheter is an easy, continuos and less time consuming method. Speed of increase of the intra-abdominal pressure seemed to be a reliable predictor for the development of an intra-abdominal compartment syndrome.
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