Figure 1From: Intra-abdominal pressure measurement using the FoleyManometer does not increase the risk for urinary tract infection in critically ill patients Modified method for intrabladder pressure monitoring as described by Malbrain (adapted from [3]with permission). Setup: - Using sterile scissors, the drainage tubing is cut 40 cm after the culture aspiration port after desinfection. - A ramp with three stopcocks is connected to a conical connection piece at each side with a male/male adaptor and inserted. - A standard intravenous (IV) infusion set is connected to a bag of 500 ml of saline and attached to the first stopcock. - A 60-ml syringe is connected to the second stopcock, and the third stopcock is connected to a pressure transducer via rigid pressure tubing. - The system is flushed with normal saline. Method of measurement: - Patient in supine position. - Zero pressure module at the midaxillary line at the level of the iliac crest (mark for future reference) by turning the proximal stopcock onto the air and the transducer. - At rest, the three stopcocks are turned 'off' to the IV bag, the syringe, and transducer giving an open way for urine to flow into the urometer - To measure IBP, the urinary drainage tubing is clamped distal to the ramp, and the third stopcock is turned 'on' to the transducer and the patient - The first stopcock is turned 'off' to the patient and 'on' to the IV infusion bag; the second stopcock is turned 'on' to the IV bag and the 60-ml syringe. - Aspirate 20-25 ml of saline from the IV bag into the syringe. - The first stopcock is turned 'on' to the patient, and the 20-25 ml of normal saline is instilled in the bladder - The first and second stopcocks are then turned 'on' to the patient and thus turned 'off' to IV tubing and the syringe. - The third stopcock already being turned 'on' to the transducer and patient allows then immediate IBP reading on the monitor.Back to article page