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Intra-Abdominal Pressure Variations in Different Body Angles and Implications for Clinical Management in Trauma
Ghada Shalaby Khalaf Mahran1, Magdy Mohammed Mahdy Sayed, Bedour Adel Mohamed
1Author Affiliations: Nursing Department, IRBID National University, Jordan. Department of Critical Care and Emergency Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt; Department of Anesthesia and Intensive Care, Faculty of Medicine, Assiut University, Assiut, Egypt; Department of Medical surgical Nursing, Faculty of Nursing, Minia University, Minia, Egypt; Maternity and pediatric nursing department, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia; Department of Critical Care and Emergency Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt; and Nursing Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University Wadi Aldawaser, Saudi Arabia.
Abstract:
Intra-abdominal pressure (IAP) is a physiological measure of great importance that can have profound clinical consequences in a range of medical diseases particularly trauma patients who are requiring fluid resuscitation. This study examines the changes in intra-abdominal pressure at 3 distinct body positions-0°, 15°, and 30° of head of bed elevation in a supine position-and its impact on trauma patients. A prospective, non-randomized comparative study involving 63 trauma patients in intensive care was carried out. Every patient's IAP was measured in 3 positions, and the mean values-and a grading system for categorizing IAP levels-were examined. IAP grades were divided into 5 levels. IAP rose as the angle of body inclination increased, reaching a maximum at 30° (21.61 ± 2.93 mm Hg). At 0° (16.17 ± 3.12 mm Hg), the lowest IAP was observed (P < .001). The grading of IAP displayed notable trends at 0° and 30°head of bed positions as grades 2, 3, and 4 were specific to abdominal trauma, showing substantially higher IAP compared to others. This study demonstrates a statistically significant correlation between head of bed elevation and intra-abdominal pressure in trauma patients. A progressive increase in IAP as the head of bed was elevated from 0° to 30°, with the highest mean IAP recorded at 30°. Furthermore, the IAP grading system highlighted that patients with abdominal trauma exhibited substantially higher IAP, particularly at 0° and 30°, falling into grades 2, 3, and 4, which are indicative of clinically significant intra-abdominal hypertension.
