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Figure 1 | Annals of Intensive Care

Figure 1

From: Intra-abdominal pressure measurement using the FoleyManometer does not increase the risk for urinary tract infection in critically ill patients

Figure 1

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.

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