0
Abstract: Poster Presentations |

THE ROLE OF URINARY BLADDER PRESSURES IN THE DIAGNOSIS OF ABDOMINAL COMPARTMENT SYNDROME: A PROSPECTIVE STUDY IN TRAUMA PATIENTS FREE TO VIEW

Samir Johna, MD, FACS; Nina Bowman, DO*; David T. Wong, MD, FACS
Author and Funding Information

Western University of Health Sciences, Pomona, CA



Chest. 2006;130(4_MeetingAbstracts):282S. doi:10.1378/chest.130.4_MeetingAbstracts.282S-c
Text Size: A A A
Published online

Abstract

PURPOSE: To evaluate the accuracy of bladder pressures in the diagnosis and management of abdominal compartment syndrome (ACS).

METHODS: After Institutional Review Board(IRB) approval, nine operative abdominal trauma patients were prospectively studied over a 18-month period. Bladder pressures were compared to pressures obtained from intra-operatively placed electronic transducer located in the pelvis. Statistical analysis was performed using methods described by Bland and Altman.

RESULTS: A Bland-Altman plot of the differences of bladder and transducer pressures against the mean pressures is shown. There is little agreement between the two methods at low (10-15 mmHg) and high (30-70 mmHg) pressures. At higher pressures, there is a significant negative bias. No patients required a re-operation. There was no mortality.

CONCLUSION: Measurements obtained from the urinary bladder did not agree well with those obtained from within the peritoneal cavity. Furthermore, abdominal pressures greater than 20 mmHg did not show signs of ACS in this selected population raising doubts about the utility of using abdominal pressures alone to manage ACS.

CLINICAL IMPLICATIONS: Based on our experience and this study, urinary bladder pressures may be inaccurate in the diagnosis and/or management of ACS. The negative bias in the urinary bladder pressures may, in fact, underestimate the true abdominal pressures. We propose that the clinical triad of acute deterioration in organ dysfunction, abdominal distention, and adequate intravascular volume be the trigger to act on the diagnosis of ACS.

DISCLOSURE: Nina Bowman, None.

Wednesday, October 25, 2006

12:30 PM - 2:00 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543