Is Urinary Bladder Pressure a Sensitive Indicator of Intra-Abdominal Pressure?

Yol, Serdar; Kartal, Adil; Tavlı, Şakir; Tatkan, Yüksel

doi:10.1055/s-2007-1001421

Cited by 55 publications

(31 citation statements)

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“…3,7,10) However, measurement of intra-abdominal pressure with a transurethral bladder catheter in 84 morbidly obese patients found that higher sagittal abdominal diameter was associated with significant increase in this pressure. 8) Intra-abdominal pressure was well above 8 mmHg and could be as high as 12 mmHg in some obese patients.…”

Section: Discussionmentioning

confidence: 99%

Preventive Stitching for Migration of a Peritoneal Catheter Into the Abdominal Wall After Ventriculoperitoneal Shunting -Technical Note-

Nakahara

Shimizu

Oka

et al. 2010

Neurol. Med. Chir.(Tokyo)

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Fig. 1 Schematic showing the suture beside the peritoneal catheter which penetrates the peritoneum, posterior and anterior sheath of rectus abdominis muscle, and subcutaneous fat to prevent formation of dead space. AbstractMigration of the distal end of a ventriculoperitoneal shunt into the abdominal wall (epi-peritoneal layer) is a complication which is especially likely in obese patients with high intra-abdominal pressure and wide dead space around the catheter remaining after laparotomy. A preventive abdominal stitching method for this complication was developed consisting of sutures beside the catheter penetrating the peritoneum, posterior and anterior sheath of rectus abdominis muscle, and subcutaneous fat. This method was applied to more than 20 patients who underwent ventriculoperitoneal shunting. No patient experienced shunt migration. The technique is easy and safe to perform, avoids leaving a dead space around the peritoneal catheter, and prevents catheter migration.

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Section: Discussionmentioning

confidence: 99%

Preventive Stitching for Migration of a Peritoneal Catheter Into the Abdominal Wall After Ventriculoperitoneal Shunting -Technical Note-

Nakahara

Shimizu

Oka

et al. 2010

Neurol. Med. Chir.(Tokyo)

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“…Tekanan intra abdomen akan naik bila volume cavum abdomen meningkat secara akut dan melebihi kapasitas yang dimilikinya. Apabila terjadi peningkatan tekanan intra abdomen yang ekstrim dapat terjadi sindroma kompartemen abdomen yang meliputi gangguan pada mekanisme respirasi, hemodinamika dan fungsi ginjal (6,7).…”

Section: Pendahuluanunclassified

“…Lavase peritoneal diagnosis (LPD) suatu metode untuk menunjang menegakkan diagnosis dari cedera intra abdomen telah digunakan secara luas karena dianggap cukup obyektif dalam menilai adanya cedera intra abdomen. Meskipun tehniknya relatif mudah dengan angka ketepatan yang melampaui 95%, dengan komplikasi sekitar 1% yaitu adanya cedera vaskuler dan perforasi organ berongga (6,7,8). Namun karena bersifat invasif dan tidak bersifat spesifik untuk organ tertentu, pemeriksaan memerlukan waktu dan menunggu hasil pemeriksaan laboraorium dan harus dengan persiapan untuk langsung melakukan laparotomi.…”

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Hubungan Peningkatan Tekanan Intravesika Urinaria Dengan Perdarahan Intraperitoneal Akibat Trauma Tumpul Abdomen

Soemarko

2013

JKB

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The diagnosis of intraperitoneal hemorrhage must be quickly with a high accuracy, before an acute exploratory laparotomy. This study was conducted to find out if intravesical pressure measurement should be as an alternative indicator of diagnostic peritoneal lavage in predicting intraperitoneal hemorrhage that indicating an acute exploratory laparotomy. Using an Explorative, Cross Sectional Design. Results of the exploratory laparotomy were used as a standard of determining the accuracy of Diagnostic Peritoneal Lavage and intravesical pressure measurement in predicting the indication for the exploratory laparotomy. 18 of 24 patients has positive results of diagnostic peritoneal lavage, but an active intraperitoneal hemorrhage only found in 15 patients, with a positive predictive value 83,33 %, negative predictive value 100%. The results of intravesical pressure measurement in the same patients predicted 17 patients has positive results, with slight a higher positive predictive value (88,24 %), negative predictive value 100%. The conclusion is the measurement of intravesical pressure is an alternative procedure of Diagnostic Peritonel lavage for predicting intraperitoneal hemorrhage.Key words: Blunt Trauma Abdomen; Intravesical Pressure Measurement; Diagnostic Peritoneal Lavage; Exploratory Laparotomy; Intraperitoneal Hemorrhage. PENDAHULUANPada cedera fisik yang memerlukan tindakan pembedahan akut didapatkan bahwa 10% diantaranya adalah akibat dari trauma tumpul didaerah abdomen. Trauma tumpul abdomen dapat menyebabkan cedera organ intra abdomen berupa ruptura organ padat seperti hepar dan lien atau perforasi organ berongga seperti lambung dan usus.Cedera intra abdomen pada pemeriksaan awal sulit untuk dideteksi. Apalagi bila penderita datang dalam keadaan tak sadar akibat trauma didaerah kepala atau akibat intoksikasi alkohol. Berdasarkan data yang berasal dari rekam medis diketahui bahwa 20% penderita dengan hemoperitoneum menunjukkan tanda tanda klinis yang benigna pada waktu pertama kali tiba di instalasi rawat darurat (1). Oleh karena itu untuk memberikan perawatan penderita secara optimal haruslah dimulai dengan evaluai awal yang teliti dengan melakukan prosedur bedah yang efektif dan efisien dalam waktu sehingga dapat secara maksimal diupayakan penyelamatan nyawa penderita. Harus diusahakan dengan benar untuk mencegah kematian yang memang seharusnya tidak terjadi (2).Untuk menegakkan diagnosis pada cedera organ pada trauma tumpul abdomen dapat menimbulkan keragu-raguan bagi ahli bedah. Tanda tanda klinis tidak selalu patognomonis menunjukkan adanya cedera organ intra abdomen. Berbeda dengan trauma terbuka atau tembus pada abdomen, pada trauma tumpul abdomen diperlukan langkah diagnosis yang lebih kompleks mengingat berbagai bentuk cedera dapat terjadi (2). Pada keadaan klinis yang meragukan dibutuhkan alat bantu tertentu untuk menegakkan diagnosis adanya cedera organ intra abdomen, sehingga dapat ditentukan ada tidaknya indikasi untuk melakukan laparotomi.Ada beberapa alat bantu diagnosis yang tel...

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“…To provide such validation, studies must be conducted where intraabdominal pressure is measured directly in patients by placement of intraperitoneal catheters. 43,44 These techniques are not standard practices in the ICU, and their use would significantly increase the risk to patients and cannot be ethically justified. The lack of direct measurement of intra-abdominal pressure is a limitation of the present study, as with all other clinical studies assessing the effects of the volume of saline instilled into the patient's bladder and position on IBP.…”

Section: Clinical Implications and Future Researchmentioning

confidence: 99%

Measuring Intrabladder Pressure With the Head of the Bed Elevated 30º: Evidence to Support a Change in Practice

Shuster

Sekula

Kern

et al. 2011

American Journal of Critical Care

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Background A 30° head-of-bed elevation is recommended for most critically ill patients. Measuring intrabladder pressure with the patient in this position is controversial. Objective To assess the feasibility of measuring intrabladder pressure with a 30° head-of-bed elevation. Methods A prospective, randomized, and experimental study. Patients had intrabladder pressure measured first while positioned supine with a 30° head-of-bed elevation and 25 mL of saline instilled into the bladder and again after the patients were randomly repositioned to supine without any head-of-bed elevation (flat) or with a 30° head-of-bed elevation while supine or in right lateral or left lateral position with either 25, 50, or 200 mL of saline instilled into the patient's bladder. Results Intrabladder pressures measured with the patient in all 3 head-of-bed elevated positions were higher than pressures measured with patients supine and flat after instillation of 25 mL of saline into the bladder, but intrabladder pressure did not differ between the 30° head-of-bed elevated positions and the supine and flat positions when 50 or 200 mL of saline was instilled into the bladder. Two-way analysis of variance showed a significant interaction between volume of saline instilled (P = .05), patient's position (P = .007), and bladder instill volume and position interaction (P = .004). Conclusion It is feasible to measure intrabladder pressure with a 30° head-of-bed elevation, and that position could be an alternative to supine positioning of patients for measurement of intrabladder pressure.

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Is Urinary Bladder Pressure a Sensitive Indicator of Intra-Abdominal Pressure?

Abstract: We concluded that bladder pressure measured by transurethral catheter was equal to insufflator pressure during laparoscopy, and that this was a valid indicator of intra-abdominal pressure.

Cited by 55 publications

References 0 publications

Preventive Stitching for Migration of a Peritoneal Catheter Into the Abdominal Wall After Ventriculoperitoneal Shunting -Technical Note-

Preventive Stitching for Migration of a Peritoneal Catheter Into the Abdominal Wall After Ventriculoperitoneal Shunting -Technical Note-

Hubungan Peningkatan Tekanan Intravesika Urinaria Dengan Perdarahan Intraperitoneal Akibat Trauma Tumpul Abdomen

Measuring Intrabladder Pressure With the Head of the Bed Elevated 30º: Evidence to Support a Change in Practice

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