Intra-abdominal Pressure

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- who has been orientated to the Intensive Care Unit;
and - who has been assessed as competent in the management of the patient undergoing intra-abdominal pressure monitoring
by the (ICU/CCU) staff.

STANDARDS : Patient Safety:
All aspects of the procedure should be carried out under strict asepsis.

Patient Comfort:
At all times, the ICU staff should attempt to:
- carefully explain all procedures to the patient, prior to their commencement.

OUTCOMES : The identification of intra-abdominal hypertension, in the clinical setting of a tense abdomen and oliguria, will enable appropriate intervention to be taken. The pathophysiological effects of raised intra-abdominal pressure include: reduced cardiac output; increased renal and systemic vascular resistance; decreased venous return; impaired visceral blood flow and altered
respiratory dynamics.


EQUIPMENT : - Foley urethral catheter (refer to the Policy / Procedure : Insertion of A Urethral Catheter if catheter not in place)
- Sterile gloves; -basic dressing pack; -antiseptic solution;
- 16 g. intravenous cannula;
- 10 cm. length three-way stopcock;
- disposable pressure monitoring kit (cat. no. 10); -pressure cable and module;
- 500 ml intravenous flask; - pressure bag;
- Luer-lock macrodrip intravenous giving set; -100 ml flask 0.9% Sodium Chloride;
- rubber- tipped forceps; adhesive tape;
- pressure transducer holder; - intravenous pole.
PROCEDURE :
- Position patient supine.
- Connect pressure monitoring equipment to three-way stopcock.
- Place pressure transducer in holder.
- Position intravenous pole to side of patient, at the level of the hips.
- Adjust height of the pressure transducer, so that the atmospheric port is level with the top of the symphysis pubis.
- Connect saline and giving set to three-way stopcock.
- Clamp urinary drainage bag, immediately below aspiration port.
- Don gloves and clean aspiration port.
- Cannulate aspiration port of urinary drainage bag.
- Remove cannula stylet and connect intravenous cannula to Luer end of three-way stopcock.
- Tape cannula and three-way stopcock to urinary drainage bag.
- Calibrate pressure transducer.
- Infuse 100ml saline into the bladder. - Store end-expiratory intra-abdominal pressure reading.
- Release clamp.
- Deduct 100ml from hourly urine output.
- ******** reading on flowchart.
- Repeat procedure every eight hours and as required.


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Intra-abdominal hypertension has been defined as a pressure reading greater than 20 mmHg.