{"id":{"repo_id":"kings","oai_identifier":"oai:kclpure.kcl.ac.uk:studenttheses/bf047b54-da8b-4a92-a05c-c22a27072827"},"canonical_url":"https://search.dev.ndltd.org/etd/kings/oai:kclpure.kcl.ac.uk:studenttheses/bf047b54-da8b-4a92-a05c-c22a27072827","repository":{"repo_id":"kings","name":"King's College London","base_url":"https://kclpure.kcl.ac.uk/ws/oai"},"display":{"title":"A Study of Raised Intra-abdominal Pressure and the Abdominal Compartment Syndrome in Liver Intensive Care","abstract":"Introduction
Interest in intra-abdominal pressure (IAP) measurement has increased significantly, with evidence of its deleterious effects demonstrated on every organ. Despite the volume of publications – several assumptions relating to the measurement of IAP remain unproven and there is a paucity of data relating to patients in a specialised liver Intensive Therapy Unit (ITU).
Methods
This thesis encompasses a survey of the available literature and national attitudes / practice with several clinical experiments; Generic Questions 1. IAP measurement technique – validation of current gold-standard against alternatives
2. Identification of potential sources of error in measurement of IAP
3. Impact of body position and zero-reference point on IAP
Specialty Specific Questions
1. Incidence of raised IAP in specialised liver ITU and its link to complications / length of stay
2. Identification of early predictors of raised IAP
3. Study of regional abdominal compartmental variation in IAP
Results & Conclusions
• IAP is widely accepted by UK anaesthetists and surgeons, especially amongst those more recently graduated. Knowledge and practice is variable however and requires better education
• The Foley Catheter Manometer represents a reliable and valid tool for the measurement of IAP, with excellent agreement to measurements obtained by other devices and directly transduced intra-peritoneal pressure
• Body-position and bladder priming volumes both introduce significant clinical error in the measurement of IAP
• Patients in liver ITU are at higher risk of developing elevated IAP than those in a general ITU. Within this patient cohort, complications are associated with elevated IAP and IAP is a better predictor of length of stay than other severity scores. A normal Day 1 IAP reliably predicts that abdominal compartment syndrome will not occur during the admission
• Significant variation in upper and lower IAP occurs following liver transplantation and this regional variation can be manipulated by body positioning","abstract_html":"Introduction<br/>Interest in intra-abdominal pressure (IAP) measurement has increased significantly, with evidence of its deleterious effects demonstrated on every organ. Despite the volume of publications – several assumptions relating to the measurement of IAP remain unproven and there is a paucity of data relating to patients in a specialised liver Intensive Therapy Unit (ITU).<br/>Methods<br/>This thesis encompasses a survey of the available literature and national attitudes / practice with several clinical experiments; Generic Questions 1. IAP measurement technique – validation of current gold-standard against alternatives<br/>2. Identification of potential sources of error in measurement of IAP<br/>3. Impact of body position and zero-reference point on IAP<br/>Specialty Specific Questions<br/>1. Incidence of raised IAP in specialised liver ITU and its link to complications / length of stay<br/>2. Identification of early predictors of raised IAP<br/>3. Study of regional abdominal compartmental variation in IAP<br/>Results &amp; Conclusions<br/>• IAP is widely accepted by UK anaesthetists and surgeons, especially amongst those more recently graduated. Knowledge and practice is variable however and requires better education<br/>• The Foley Catheter Manometer represents a reliable and valid tool for the measurement of IAP, with excellent agreement to measurements obtained by other devices and directly transduced intra-peritoneal pressure<br/>• Body-position and bladder priming volumes both introduce significant clinical error in the measurement of IAP<br/>• Patients in liver ITU are at higher risk of developing elevated IAP than those in a general ITU. Within this patient cohort, complications are associated with elevated IAP and IAP is a better predictor of length of stay than other severity scores. A normal Day 1 IAP reliably predicts that abdominal compartment syndrome will not occur during the admission <br/>• Significant variation in upper and lower IAP occurs following liver transplantation and this regional variation can be manipulated by body positioning","abstract_has_math":false,"creators":["Cresswell, Ben"],"institution":"King's College London","degree_name":"Doctor of Medicine by Research","degree_level":"Doctoral Thesis","degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Wendon, Julia Alexis"],"committee_chairs":[],"committee_members":[],"year":2013,"date_issued":"2013-7-1","date_published":"2013-7-1","updated_at":"2026-07-24T02:44:34Z","subjects":[],"languages":["eng"],"rights":[],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["oai:kclpure.kcl.ac.uk:studenttheses/bf047b54-da8b-4a92-a05c-c22a27072827"],"render_values":[{"text":"oai:kclpure.kcl.ac.uk:studenttheses/bf047b54-da8b-4a92-a05c-c22a27072827","href":null,"code":true}]}]},"links":{"outbound_url":"https://kclpure.kcl.ac.uk/portal/en/studentTheses/bf047b54-da8b-4a92-a05c-c22a27072827","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Wendon, Julia Alexis"]},{"key":"dc:creator","label":"Author","values":["Cresswell, Ben"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2013-7-1"]},{"key":"dc:date.issued","label":"Date","values":["2013-7-1"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Institute of Liver Sciences"]},{"key":"dc:publisher.institution","label":"Dc Publisher Institution","values":["King's College London"]},{"key":"dc:relation.isreferencedby","label":"Dc Relation Isreferencedby","values":["https://kclpure.kcl.ac.uk/portal/en/studentTheses/bf047b54-da8b-4a92-a05c-c22a27072827"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Doctoral Thesis"]},{"key":"dc:type.qualificationname","label":"Dc Type Qualificationname","values":["Doctor of Medicine by Research"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["eng"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["oai:kclpure.kcl.ac.uk:studenttheses/bf047b54-da8b-4a92-a05c-c22a27072827","https://kclpure.kcl.ac.uk/portal/en/studentTheses/bf047b54-da8b-4a92-a05c-c22a27072827"]},{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://kclpure.kcl.ac.uk/portal/files/12525400/Studentthesis-Ben_Cresswell_2013.pdf"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Introduction
Interest in intra-abdominal pressure (IAP) measurement has increased significantly, with evidence of its deleterious effects demonstrated on every organ. Despite the volume of publications – several assumptions relating to the measurement of IAP remain unproven and there is a paucity of data relating to patients in a specialised liver Intensive Therapy Unit (ITU).
Methods
This thesis encompasses a survey of the available literature and national attitudes / practice with several clinical experiments; Generic Questions 1. IAP measurement technique – validation of current gold-standard against alternatives
2. Identification of potential sources of error in measurement of IAP
3. Impact of body position and zero-reference point on IAP
Specialty Specific Questions
1. Incidence of raised IAP in specialised liver ITU and its link to complications / length of stay
2. Identification of early predictors of raised IAP
3. Study of regional abdominal compartmental variation in IAP
Results & Conclusions
• IAP is widely accepted by UK anaesthetists and surgeons, especially amongst those more recently graduated. Knowledge and practice is variable however and requires better education
• The Foley Catheter Manometer represents a reliable and valid tool for the measurement of IAP, with excellent agreement to measurements obtained by other devices and directly transduced intra-peritoneal pressure
• Body-position and bladder priming volumes both introduce significant clinical error in the measurement of IAP
• Patients in liver ITU are at higher risk of developing elevated IAP than those in a general ITU. Within this patient cohort, complications are associated with elevated IAP and IAP is a better predictor of length of stay than other severity scores. A normal Day 1 IAP reliably predicts that abdominal compartment syndrome will not occur during the admission
• Significant variation in upper and lower IAP occurs following liver transplantation and this regional variation can be manipulated by body positioning"]},{"key":"dc:title","label":"Title","values":["A Study of Raised Intra-abdominal Pressure and the Abdominal Compartment Syndrome in Liver Intensive Care"]}]}],"canonical_facts":{"dc:contributor.advisor":["Wendon, Julia Alexis"],"dc:creator":["Cresswell, Ben"],"dc:date":["2013-7-1"],"dc:date.issued":["2013-7-1"],"dc:description.abstract":["Introduction
Interest in intra-abdominal pressure (IAP) measurement has increased significantly, with evidence of its deleterious effects demonstrated on every organ. Despite the volume of publications – several assumptions relating to the measurement of IAP remain unproven and there is a paucity of data relating to patients in a specialised liver Intensive Therapy Unit (ITU).
Methods
This thesis encompasses a survey of the available literature and national attitudes / practice with several clinical experiments; Generic Questions 1. IAP measurement technique – validation of current gold-standard against alternatives
2. Identification of potential sources of error in measurement of IAP
3. Impact of body position and zero-reference point on IAP
Specialty Specific Questions
1. Incidence of raised IAP in specialised liver ITU and its link to complications / length of stay
2. Identification of early predictors of raised IAP
3. Study of regional abdominal compartmental variation in IAP
Results & Conclusions
• IAP is widely accepted by UK anaesthetists and surgeons, especially amongst those more recently graduated. Knowledge and practice is variable however and requires better education
• The Foley Catheter Manometer represents a reliable and valid tool for the measurement of IAP, with excellent agreement to measurements obtained by other devices and directly transduced intra-peritoneal pressure
• Body-position and bladder priming volumes both introduce significant clinical error in the measurement of IAP
• Patients in liver ITU are at higher risk of developing elevated IAP than those in a general ITU. Within this patient cohort, complications are associated with elevated IAP and IAP is a better predictor of length of stay than other severity scores. A normal Day 1 IAP reliably predicts that abdominal compartment syndrome will not occur during the admission
• Significant variation in upper and lower IAP occurs following liver transplantation and this regional variation can be manipulated by body positioning"],"dc:identifier":["oai:kclpure.kcl.ac.uk:studenttheses/bf047b54-da8b-4a92-a05c-c22a27072827","https://kclpure.kcl.ac.uk/portal/en/studentTheses/bf047b54-da8b-4a92-a05c-c22a27072827"],"dc:identifier.uri":["https://kclpure.kcl.ac.uk/portal/files/12525400/Studentthesis-Ben_Cresswell_2013.pdf"],"dc:language":["eng"],"dc:publisher.department":["Institute of Liver Sciences"],"dc:publisher.institution":["King's College London"],"dc:relation.isreferencedby":["https://kclpure.kcl.ac.uk/portal/en/studentTheses/bf047b54-da8b-4a92-a05c-c22a27072827"],"dc:title":["A Study of Raised Intra-abdominal Pressure and the Abdominal Compartment Syndrome in Liver Intensive Care"],"dc:type":["Thesis"],"dc:type.qualificationlevel":["Doctoral Thesis"],"dc:type.qualificationname":["Doctor of Medicine by Research"]},"updated_at":"2026-07-24T02:44:34Z"}