Figure 2

Intrabladder pressure monitoring with the FoleyManometerLV. This technique that uses the patient's own urine as pressure transmitting medium is a simple, reliable, and cost-effective clinical tool. Based on a modified version of the IAP monitoring technique described by Malbrain [3], the disposable FoleyManometer provides a closed sterile circuit which connects between the patient's Foley catheter and the urine collection device. Each IAP determination takes about 10 s, and no subsequent correction of urine output is required. The technique uses a low bladder infusion volume, has a needle-free sampling port, and can measure IAP in a range from 0 to 40 mmHg. A Initial setup: - Open the FoleyManometer LV pouch and close the tube clamp. - Place the urine collection device under the patient's bladder and tape the drainage tube to the bed sheet. - Insert the FoleyManometer between catheter and drainage device. - Prime the FoleyManometer with 20 ml of sterile saline through its needle-free injection/sampling port. - Prime only once at initial setup B Urine drainage: - Let the urine drain in between IBP measurements. - Urine sampling from the needle-free port is facilitated by temporarily opening the red clamp. Remember to close clamp afterward. - Avoid a U-bend of the large urimeter drainage tube (which will impede urine drainage). - Replace the FoleyManometer whenever the Foley catheter or the urine collection device is replaced, or at least every 7 days. C Intravesical pressure monitoring: - Place the '0-mmHg' mark of the manometer tube at the midaxillary line at the level of the iliac crest (mark for future reference) and elevate the filter vertically above the patient. - Open the bio-filter clamp and read IBP (end-expiration value) when the meniscus has stabilized after about 10 s. - Close clamp after IBP measurement and place the FoleyManometer in its drainage position.