Hemodynamic effects of increased intra-abdominal pressure in critically ill children

Silveira, Letícia G.T.; Brocca, Isabela C.; Moraes, Érika Sana; Brandão, Marcelo Barciela; Nogueira, Roberto José Negrão; Souza, Tiago Henrique de

doi:10.1016/j.jped.2020.11.002

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…The time latency between IAP elevation, clinical deterioration, time of transition to ACS, and the subsequent decision to perform a DL is crucial for the prognosis. Silveira et al demonstrated that even a low level of IAH in children can lead to cardiac dysfunction [16].…”

Section: Prognosis Of Children Suffering From Acsmentioning

confidence: 99%

Awareness and diagnosis for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in neonatal (NICU) and pediatric intensive care units (PICU) – a follow-up multicenter survey

et al. 2023

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Background Constantly elevated intra-abdominal pressure (IAH) can lead to abdominal compartment syndrome (ACS), which is associated with organ dysfunction and even multiorgan failure. Our 2010 survey revealed an inconsistent acceptance of definitions and guidelines among pediatric intensivists regarding the diagnosis and treatment of IAH and ACS in Germany. This is the first survey to assess the impact of the updated guidelines on neonatal/pediatric intensive care units (NICU/PICU) in German-speaking countries after WSACS published those in 2013. Methods We conducted a follow-up survey and sent 473 questionnaires to all 328 German-speaking pediatric hospitals. We compared our findings regarding awareness, diagnostics and therapy of IAH and ACS with the results of our 2010 survey. Results The response rate was 48% (n = 156). The majority of respondents was from Germany (86%) and working in PICUs with mostly neonatal patients (53%). The number of participants who stated that IAH and ACS play a role in their clinical practice rose from 44% in 2010 to 56% in 2016. Similar to the 2010 investigations, only a few neonatal/pediatric intensivists knew the correct WSACS definition of an IAH (4% vs 6%). Different from the previous study, the number of participants who correctly defined an ACS increased from 18 to 58% (p < 0,001). The number of respondents measuring intra-abdominal pressure (IAP) increased from 20 to 43% (p < 0,001). Decompressive laparotomies (DLs) were performed more frequently than in 2010 (36% vs. 19%, p < 0,001), and the reported survival rate was higher when a DL was used (85% ± 17% vs. 40 ± 34%). Conclusions Our follow-up survey of neonatal/pediatric intensivists showed an improvement in the awareness and knowledge of valid definitions of ACS. Moreover, there has been an increase in the number of physicians measuring IAP in patients. However, a significant number has still never diagnosed IAH/ACS, and more than half of the respondents have never measured IAP. This reinforces the suspicion that IAH and ACS are only slowly coming into the focus of neonatal/pediatric intensivists in German-speaking pediatric hospitals. The goal should be to raise awareness of IAH and ACS through education and training and to establish diagnostic algorithms, especially for pediatric patients. The increased survival rate after conducting a prompt DL consolidates the impression that the probability of survival can be increased by timely surgical decompression in the case of full-blown ACS.

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Section: Prognosis Of Children Suffering From Acsmentioning

confidence: 99%

Awareness and diagnosis for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in neonatal (NICU) and pediatric intensive care units (PICU) – a follow-up multicenter survey

et al. 2023

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Comparison of Deep and Moderate Neuromuscular Blockade for Major Laparoscopic Surgery in Children: A Randomized Controlled Trial

Wei,

Li,

Chen

et al. 2024

Pediatr Drugs

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Monitoring and Management of Intra-abdominal Pressure in Critically Ill Children

Wang

2023

Critical Care Nurse

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Background Intra-abdominal hypertension is a comorbid condition in critically ill children, is an independent predictor of mortality, and has harmful effects on multiple organ systems through renal, pulmonary or hemodynamic damage. Intra-abdominal pressure monitoring is widely used in clinical practice because it is a safe, accurate, inexpensive, and rapid method for the clinical diagnosis of intra-abdominal hypertension. Objective To improve pediatric critical care nurses’ understanding of and ability to perform intra-abdominal pressure monitoring and provide a reference for standardizing intra-abdominal pressure monitoring in clinical practice. Methods A literature review was performed using the following keywords: intra-abdominal pressure, bladder pressure, vesicular pressure, measurement, monitoring, critically ill children, pediatric intensive care, pediatric, and children. Four hundred fifty-four articles were initially identified and screened; 24 were included. Results The monitoring and management of intra-abdominal pressure should include appropriate and clinically proven intra-abdominal pressure measurement techniques, appropriate patients, the proper frequency of measurement, and a repeatable intra-abdominal pressure measurement method. Conclusions Knowledge of intra-abdominal pressure monitoring in critically ill children enhances the ability of nurses in clinical practice to accurately measure intra-abdominal pressure to improve the timeliness and accuracy of clinical identification of intra-abdominal hypertension and guide decompression interventions.

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Hemodynamic effects of increased intra-abdominal pressure in critically ill children

Cited by 3 publications

References 29 publications

Awareness and diagnosis for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in neonatal (NICU) and pediatric intensive care units (PICU) – a follow-up multicenter survey

Awareness and diagnosis for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in neonatal (NICU) and pediatric intensive care units (PICU) – a follow-up multicenter survey

Comparison of Deep and Moderate Neuromuscular Blockade for Major Laparoscopic Surgery in Children: A Randomized Controlled Trial

Monitoring and Management of Intra-abdominal Pressure in Critically Ill Children

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