Intra-abdominal Pressure (IAP) can be easily monitored by measuring bladder pressure. Measurement
of intraluminal bladder pressure consists of instilling about 50 mL of
saline into the urinary bladder through the Foley catheter. The tubing
of the collecting bag is clamped, and a needle is inserted into the
specimen-collecting port of the tubing proximal to the clamp and is
attached to a manometer. Bladder pressure (measured in mm Hg) is the
height at which the level of the saline column stabilizes with the symphysis pubis as the zero point.
Grading
In an excellent group of articles, Burch et al developed a grading system. Patients with higher-grade abdominal compartment syndrome have end-organ damage, which is evidenced by splenic hypercarbia and elevated lactate levels, even if they appear clinically stable. The following grading system has become accepted if IAH is present:
Grade I: 10-15 cm H2 O
Grade II: 15-25 cm H2 O
Grade III: 25-35 cm H2 O
Grade IV, greater than 35 cm H2 O
Grading
In an excellent group of articles, Burch et al developed a grading system. Patients with higher-grade abdominal compartment syndrome have end-organ damage, which is evidenced by splenic hypercarbia and elevated lactate levels, even if they appear clinically stable. The following grading system has become accepted if IAH is present:
Grade I: 10-15 cm H2 O
Grade II: 15-25 cm H2 O
Grade III: 25-35 cm H2 O
Grade IV, greater than 35 cm H2 O
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