| Abstract: Introduction Recently it has been proposed that abdominal perfusion pressure (APP), which is the mean arterial pressure minus the intra-abdominal pressure (IAP); [(APP mmHg)= MAP-IAP)], is a superior monitoring tool to predict the abdominal compartment syndrome (ACS) than conventional IAP measurements alone (1). This study describes a new technique using new continuous intra-abdominal pressure measurement to measure continuous abdominal perfusion pressure measurement.
Materials and Methods A prospective study of five ICU patients was undertaken between October 1st and November 1st, 2003 a university teaching hospital. All patients had a Size 18 Fr three-way urinary catheter (2,3)with continuous IAPs performed via the irrigation port of the three-way catheter, in which continuous normal saline irrigation (4 ml/hr) was maintained and connected through a two-way stopcock and normal saline filled tubing to a pressure transducer placed in-line with the iliac crest at mid axillary line The continuous IAP measurement was recorded on the bedside monitor, as was the mean arterial pressure. Abdominal perfusion pressure was calculated as the main arterial pressure minus the intra-abdominal pressure. Print outs of actual values were given every 15 minutes.
Results Five patients mean age 59.3 years, mean body mass index 28.5±13.7 had APPs ranging from 31-110 over the 12 hours. The mean APP (mmHg) was 61.8± 5.1 range 56.4-69.6. Of the 240 readings in the 5 patients only four spurious results were recorded
The technique allows continuous abdominal perfusion pressure monitoring and provides an additional monitoring option in patients with intra-abdominal hypertension.
|
