Chapters authored
Intra-Abdominal Hypertension and Abdominal Compartment Syndrome in Critically Ill Surgical Patients (Special Findings in Severe Acute Pancreatitis)
Part of the book: Pancreatitis
Intra-Abdominal Pressure Monitoring
Pancreatitis, inflammatory processes or retroperitoneal haemorrhage, paralytic ileus, ascites, severe visceral oedema caused by extreme fluid replacement, blunt abdominal trauma, peritonitis, or even massive transfusion can be found among the triggering factors of intra-abdominal hypertension and abdominal compartment syndrome (ACS). The only possible way of establishing the diagnosis is to measure the intra-abdominal pressure (IAP), a widespread manner of which is the measurement through the bladder. In our works, we wanted to study whether the method of continuous intra-abdominal pressure monitoring is feasible within the everyday practice of diagnosing the conditions having increased intra-abdominal pressure. The globally accepted pressure measurement carried out through a urinary catheter and its classical so-called intermittent form has been employed worldwide in the intensive care units and surgical wards. The procedure is simple, yet time consuming, and the catheter connections and disconnections are sources of infection. The measurement results provide information only on the individual pressure values of the predetermined measurement dates. In order to eliminate these weaknesses and for the safe and quick measurements, the classical technique was replaced by a completely new method: the continuous intra-abdominal pressure monitoring. In order to determine the objectivity of the continuous intra-abdominal pressure measurement technique, we carried out a validation study on surgical patients with normal and elevated intra-abdominal pressures. The pressure was determined by both methods in case of all patients. Significant difference could not be observed between the results of the intermittent and of the new technique. In this chapter, we want to discuss in detail of this validation study appointing the strong advantages of the new monitoring process. Measurement of the intra-abdominal pressure is essential in the differential diagnosis of acute abdominal pathologies. Pressure measurement through urinary catheters for the monitoring of the intra-abdominal pressure, especially its continuous variant, is an excellently applicable method. Introduction into the daily clinical routine is highly recommended.
Part of the book: Bedside Procedures