What are the commercially available intra-abdominal pressure (IAP)-monitoring devices for bladder pressure assessment?

Updated: Jan 16, 2020
  • Author: Pamela I Ellsworth, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Manufacturers have developed simple, easy-to-use systems that allow for frequent IAP monitoring, enabling early intervention, when appropriate. Such “preassembled kits significantly reduce setup time, reduce the margin for monitoring error by maintaining consistency of setup, and reduce the risk of system contamination during assembly.” [25]

The commercially available IAP devices require the patient to be placed fully supine in order to ensure consistent measurements. [26] Even a small elevation in head position or body position can alter the pressure readings. [27] The patient must have no abdominal contraction present, with the transducer placed at the level of the iliac crest at the midaxillary line or at the level of the symphysis pubis, depending on the kit.

All of the preassembled kit devices are endorsed by the World Society of the Abdominal Compartment Syndrome, but AbViser (ConvaTec) is the only one validated to provide reproducible results both for the same nurse and for other providers. [28, 15]

Two other commercial kits are also available for IAP monitoring, the Bard IAP monitoring device and the UnoMeter Abdo-Pressure kit (formerly the Holtech Medical Foley manometer [Unomedical a/s, A ConvaTec company]).

The Bard IAP Monitoring Device maintains a closed urinary drainage system to prevent catheter-associated urinary tract infections. [18] It also contains a valve port that allows saline infusions through the sampling port on the catheter and still allows for obtaining urine for samples.

The UnoMeter Abdo-Pressure kit is a manometer-type device that does not require reassembly. [14] It requires only a single priming at setup with a needle-free injection/sampling port (unless air is found in the tube) and measures in mm Hg for ease with use of the IACS management recommendations and so decreases the risk for calculation error. However, still require opening to air with a clamp.


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