Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine.
Department of Neurosurgery, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine.
J Vis Exp. 2021 May 11(171). doi: 10.3791/62557.
Intra-abdominal pressure (IAP) is increasingly being recognized as an indispensable and significant physiological parameter in intensive care units (ICU). IAP has been measured in a variety of ways with the development of many techniques in recent years. The level of intra-abdominal pressure under normal conditions is generally equal to or less than 12 mmHg. Accordingly, abdominal hypertension (IAH) is defined as two consecutive IAP measurements higher than 12 mmHg within 4-6 h. When IAH deteriorates further with IAP higher than 20 mmHg along with organ dysfunction and/or failure, this clinical manifestation can be diagnosed as abdominal compartment syndrome (ACS). IAH and ACS are associated with gastrointestinal ischemia, acute renal failure, and lung injury, leading to severe morbidity and mortality. Elevated IAP and IAH may affect the cerebral venous return and outflow of the cerebrospinal fluid by increasing the intrathoracic pressure (ITP), ultimately leading to increased intracranial pressure (ICP). Therefore, it is essential to monitor IAP in critically ill patients. The reproducibility and accuracy of intra-bladder pressure (IBP) measurements in previous studies need to be further improved, although the indirect measurement of IAP is now a widely used technique. To address these limitations, we recently used a set of IAP monitoring systems with advantages of convenience, continuous monitoring, digital visualization, and long-term IAP recording and data storage in critically ill patients. This IAP monitoring system can detect intra-abdominal hypertension and potentially analyze clinical status in real time. The recorded IAP data and other physiological indicators, such as intracranial pressure, can be further used for correlation analysis to guide treatment and predict a patient's possible prognosis.
腹腔内压（IAP）越来越被认为是重症监护病房（ICU）中不可或缺的重要生理参数。近年来，随着许多技术的发展，IAP 已经有了多种测量方法。在正常情况下，腹腔内压的水平一般等于或小于 12mmHg。因此，腹内高压（IAH）被定义为在 4-6 小时内连续两次 IAP 测量值高于 12mmHg。当 IAH 进一步恶化，IAP 高于 20mmHg，同时伴有器官功能障碍和/或衰竭时，这种临床表现可以诊断为腹腔间隔室综合征（ACS）。IAH 和 ACS 与胃肠道缺血、急性肾衰竭和肺损伤有关，导致严重的发病率和死亡率。升高的 IAP 和 IAH 可能会通过增加胸腔内压（ITP）来影响脑静脉回流和脑脊液的流出，最终导致颅内压（ICP）升高。因此，监测危重病患者的 IAP 非常重要。尽管间接测量 IAP 现在是一种广泛使用的技术，但以前研究中膀胱内压（IBP）测量的可重复性和准确性需要进一步提高。为了解决这些限制，我们最近在危重病患者中使用了一套具有方便、连续监测、数字化可视化和长期 IAP 记录和数据存储优势的 IAP 监测系统。这种 IAP 监测系统可以检测到腹内高压，并有可能实时分析临床状况。记录的 IAP 数据和其他生理指标，如颅内压，可以进一步用于相关分析，以指导治疗并预测患者的可能预后。
