Intra-Abdominal Pressure Monitoring By Nurses For Early Detection Of Abdominal Compartment Syndrome And Early Decompressed Laparotomy In Comparison With Need To Laparotomy By Physical Exam.

ABSTRACT

Background& Objective:Abdominal compartment syndrome is as potentially lethal condition caused by any event that produces intra-abdominal hypertension. The most common cause is blunt abdominal trauma. Increasing intra-abdominal pressure affects much vital body system. Hemodynamic, respiratory, renal and neurological abnormalities are hallmark of ACS. All authors are agreeing that decompression laparotomy is the treatment of choice for the ACS. Nursing care involves vigilant monitoring for early detection including serial measurement of intra-abdominal pressure (from urinary bladder). This study was designed to investigate the comparative effect of measurement of intra-abdominal pressure and physical exam in patient with ACS for refer the patients to operation room. Methodology:In this research ACS was defined as abdominal distention with intra-abdominal pressure ≥15 mm Hg (20cm H2O) accompanied by at least two of the following oliguria or anuria, hypoxemia and hypotension or shock. When ACS detected by researcher, compared with diagnose of need to laparotomy by physician both timely and numerically.Results:Of 100 patients admitted over 8 months, 28 patients had abdominal compartment syndrome, 21 of this patients refer to operation room by physician. According to numeral comparison between two group not significant (P>.05) but according the time measuring abdominal pressure for detection of need to decompressed laparotomy significantly decreased than physical exam (p<.05).Conclusion:The ACS is a potentially lethal condition occurs in a significant number of severely blunt abdominal trauma patients and it develops quickly. Preventative therapy should be instituted to minimize its development in patients at risk and monitoring of intraabdominal pressure may allow prompt treatment of this condition rather than physical exam.