A Study of Intra-abdominal Pressure Measurement Using a New Innovative Technique with Foley's Catheter

Abstract

Aim: We aimed to study intra-abdominal pressure (IAP) measurement using a new innovative technique with Foley's catheter. Introduction: Intra-abdominal hypertension (IAH) is defined as an IAP equal to or above 12 mmHg (16.31 cm of water) (1 mmHg = 1.3 cm of water) and abdominal compartment syndrome (ACS) is defined as an IAP above 20 mmHg along with organ malfunction. Effect of increased intra-abdominal tension is acute renal failure, pulmonary dysfunction, and decreased blood flow to the gastrointestinal organs. It may cause diaphragm elevation along with an increase in intrathoracic pressure causing pulmonary dysfunction and a decrease in the venous return to the brain leading to intracranial congestion and brain dysfunction. Increased IAP is commonly measured by recording intravesical pressure. In this study, we are using 50 ml of saline for urinary bladder pressure measurement through Foley's catheter. Methods: In this prospective study, we measured IAP by Foley's catheter in the urinary bladder in 250 patients which were admitted to our hospital. In this study, 196 patients were male and 54 patients were female. After establishing normal values in routine patients, the IAP was derived above which the values were considered as IAH. Results: Patients with laparoscopic abdominal surgeries, for example, laparoscopic appendectomy and/or laparoscopic cholecystectomy, obstructed hernia (enterocele) and intestinal obstruction, pancreatic ascites, pneumothorax, alcoholic liver disease with ascites, and chronic obstructive pulmonary disease, had raised IAP as compared to others. The average IAP of our patients who were routine patients was 7–9 cm of water. IAH was considered when values were above 9 cm of water. Conclusion: Our study showed that intravesical pressure measurement is a simple, minimally invasive method that may reliably estimate IAP in patients placed in supine position. When applied clinically, this should alert the clinician to take safety measures to avoid ACS.