Harrahill's technique: a simple screening test for intra-abdominal pressure measurement

Area of Science:

• Surgical critical care
• Abdominal surgery
• Intensive care medicine

Background:

• Giant incisional hernia repair can increase intra-abdominal pressure (IAP), potentially leading to abdominal compartment syndrome.
• Intra-abdominal pressure measurement is crucial for managing these complications.
• Kron's technique is the gold standard, while Harrahill's urinary drainage manometry offers a simpler alternative.

Purpose of the Study:

• To evaluate the correlation, reproducibility, and effectiveness of Harrahill's urinary drainage manometry (UDM) for measuring intra-abdominal pressure.
• To compare UDM with Kron's invasive method (IVM).

Main Methods:

• A prospective cohort study involving 43 patients undergoing elective abdominal surgery with laparotomy.
• Comparative measurements of IAP were performed using both Kron's (IVM) and Harrahill's (UDM) techniques.
• Patients were monitored in the intensive care unit with urinary catheters.

Main Results:

• High correlation (Pearson's r = 0.97) was found between UDM and IVM, with median IAPs of 10.0 mmHg and 9.8 mmHg, respectively.
• UDM demonstrated excellent reproducibility, with a correlation coefficient of r = 0.97 in repeated measurements.
• The average difference between UDM and IVM was minimal (-0.2 +/- 0.9 mmHg).

Conclusions:

• Harrahill's technique shows good correlation and high reproducibility compared to the gold standard Kron method for IAP measurement.
• UDM is a suitable, quick, and simple screening tool for intra-abdominal hypertension, particularly after giant incisional hernia repair.