Abstract
Objectives
To compare measurements of intraabdominal pressure (IAP) via a naso-gastric tube with the previously validated technique of IAP measurement via a urinary bladder catheter. To examine an association between elevated IAP and oliguric acute renal failure.
Design
Simultaneous paired measurements of gastric and urinary bladder pressures in supine patients.
Setting
The general intensive care units of two London hospitals.
Patients
141 Paired measurements of intragastric and urinary bladder pressures were obtained in 26 general intensive care patients.
Measurements and results
With the patient lying supine, 50 ml of sterile water were instilled via manometer tubing into the stomach and bladder following drainage of each viscera. The mid-axillary line was used as the zero reference, and cavity pressures noted in centimeters of water (cmH2O) at end expiration. The results were compared using the technique of Bland and Altman.
Results
Gastric pressure may be approximately 2.5 cmH2O above or below urinary bladder pressure. Manometric measurement of the gastric pressure via a naso-gastric tube provides a simple, reliable, non-invasive technique of IAP measurement. IAP should be regularly monitored in patients with abdominal distension at risk of acute renal failure.
This is a preview of subscription content, log in via an institution to check access.
References
Bradley SE, Bradley GP (1947) The effect of increased intra-abdominal pressure on renal function in man. J Clin Invest 26:1010–1022
Harmann PK, Kron IL, McLachlan HD, Freedlender AE, Nolan SP (1982) Elevated intra-abdominal pressure and renal function. Ann Surg 196:594–597
Richards WO, Scovill W, Shin B, Reed W (1983) Acute renal failure associated with increased intra-abdominal pressure. Ann Surg 197:183–187
Iberti TJ, Lieber CE, Benjamin E (1989) Determination of intra-abdominal pressure using a transurethral bladder catheter: clinical validation of the technique. Anesthesiology 70:47–50
Platell C, Hall J, Dobb G (1990) Impaired renal function due to raised intraabdominal pressure. Intensive Care Med 16:328–329
Cullen DJ, Coyle JP, Teplick R, Long MC (1989) Cardiovascular, pulmonary, and renal effects of massively increased intra-abdominal pressure in critically ill patients. Crit Care Med 17:118–121
Fisher M (1990) Raised intra-abdominal pressure, renal failure, and the bumble bee. Intensive Care Med 16:285–286
Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet I:307–310
Kron IL, Harman PK, Nolan SP (1984) The measurement of intra-abdominal pressure as a criterion for abdominal re-exploration. Ann Surg 199:28–30
Grillner S, Nilsson J, Thorstensson A (1978) Intra-abdominal pressure changes during natural movements in man. Acta Physiol Scand 103:275–283
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Collee, G.G., Lomax, D.M., Ferguson, C. et al. Bedside measurement of intra-abdominal pressure (IAP) via an indwelling naso-gastric tube: Clinical validation of the technique. Intensive Care Med 19, 478–480 (1993). https://doi.org/10.1007/BF01711092
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01711092