Q Please describe the procedure for monitoring intra-abdominal pressure via an indwelling urinary catheter.

A John J. Gallagher, RN, MSN, CCNS, CCRN, RRT, replies:

Measurement of bladder pressure via an indwelling urinary catheter is a simple and effective way of indirectly measuring intra-abdominal pressure. Serial monitoring of bladder pressures is useful in detecting the onset of intra-abdominal hypertension (IAH) and the progression to the more severe condition, abdominal compartment syndrome (ACS). IAH and ACS occur when the abdominal contents expand in excess of the capacity of the abdominal cavity. Causes of IAH and ACS include intraperitoneal blood, interstitial edema from fluid resuscitation, peritonitis, ascites, and gaseous bowel distention. Additionally, the presence of intra-abdominal packing, use of a pneumatic antishock garment, insufflation of the peritoneum during laparoscopic procedures, and full closure of the abdominal wall in patients with visceral edema have been implicated in the development of IAH and ACS.1...

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