Measuring Abdominal Pressure in Trauma Patients

A simple fluid-column manometry device can be created to measure intra-abdominal pressure in trauma patients, which can help doctors decide what life-saving efforts to undertake.

Trauma patients who have serious injuries in the abdominal region are at risk of developing abdominal compartment syndrome, a potentially life-threatening condition. The rising fluid compresses internal organs and structures, resulting in increased airway pressure, restriction of blood returning to the heart, and diminished urinary output. Current methods to measure intra-abdominal pressure are cumbersome.

Researchers at the division of trauma surgery and critical care at Cedars-Sinai Medical Center (Los Angeles, CA, USA) have devised a new technique that is inexpensive, easy to perform, and as useful as the alternatives. They insert a Foley catheter into the patient's bladder and apply readily available silk tape to the drainage tubing so that reference points of 1 cm increments can be marked. This creates a fluid-column manometry device when the bladder is filled with sterile saline and the tubing is elevated from horizontal to vertical.

Intra-abdominal pressure is "estimated by the height of the water column, which easily can be determined hourly,” say the authors. "It is the trend of the abdominal compartment pressure that is observed using this method, and detection of an upward trend in pressure can quickly and efficiently guide timely further intervention.” Their solution was reported in the May 2002 issue of Contemporary Surgery.





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