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 4 publications

(2 citation statements)

References 29 publications

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“…Direct compression of the inferior vena cava and portal vein decreases preload and consequently cardiac output. Increased intra-thoracic pressure from elevation of the diaphragm leads to compression of the heart, decreasing ventricular end-diastolic volume and consequently cardiac output [23]. Increased systemic vascular resistance due to direct compression of abdominal vascular beds results in an initial increase in mean arterial pressure.…”

Section: Pathophysiology Of Abdominal Compartment Syndromementioning

confidence: 99%

Abdominal Compartment Syndrome in Children: Perioperative Concerns and Considerations ACS in Children

Fanelli,

Barbieri,

Grap

et al. 2024

AJPN

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The consequences of increased intra-abdominal hypertension (IAH), specifically its effects on the cardiovascular, pulmonary and renal systems are well described [3,4]. In pediatric populations, the detrimental effect of increased IAP following repair of omphalocele and gastroschisis are well known [5]. Despite this, emergent abdominal decompression for ACS in children was not described until 2000 [6][7][8]. In 2004, the World Society on Abdominal Compartment Syndrome (WSACS) was founded and published consensus definitions in 2006 [9]. These definitions were last updated in 2013 and include clinical practice guidelines and recommendations for both the adult and pediatric population [10] (Table 1).

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Section: Pathophysiology Of Abdominal Compartment Syndromementioning

confidence: 99%

Abdominal Compartment Syndrome in Children: Perioperative Concerns and Considerations ACS in Children

Fanelli,

Barbieri,

Grap

et al. 2024

AJPN

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

Cited by 4 publications

References 29 publications

Abdominal Compartment Syndrome in Children: Perioperative Concerns and Considerations ACS in Children

Abdominal Compartment Syndrome in Children: Perioperative Concerns and Considerations ACS in Children

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

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