Abdominal compartment syndrome monitoring in neonates with an acute abdomen - A pilot, retrospective, observational study.

Abdomen, Acute Humans Infant, Newborn Infant, Newborn, Diseases Intra-Abdominal Hypertension Monitoring, Physiologic / methods Pilot Projects Retrospective Studies
Abdominal compartment syndrome Intra-abdominal pressure Intravesical pressure

Journal

Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631

Informations de publication

Date de publication:
Jul 2020
Historique:
received: 15 04 2019
revised: 30 07 2019
accepted: 07 08 2019
pubmed: 23 11 2019
medline: 19 12 2020
entrez: 23 11 2019
Statut: ppublish

Résumé

Abdominal compartment syndrome (ACS) is a pathological increase of the intra-abdominal pressure (IAP) with dysfunction of one or more organs. There is lack of clarity in neonates regarding what intravesical pressure (IVP) value, a surrogate marker for IAP, indicates the need for intervention for ACS. The medical records at a Children's Hospital NICU were reviewed to identify all neonates that had IVP/s monitored over a 10-year period (2008-2017). Demographic parameters, IVPs, and important clinical outcomes were obtained. Associations between IVP monitoring and clinical outcomes were explored. Forty-six neonates had IVP monitoring, with 4 (8%) being diagnosed with ACS requiring further operative intervention. There was no significant correlation between IVP and need for surgery. There was a significant positive correlation between the maximum IVP and the need for total parenteral nutrition (rs = 0.350, p = 0.017), ventilator support (rs = 0.321, p = 0.034) and length of stay (rs = 0.362, p = 0.016) and between a diagnosis of ACS and neonatal mortality (rs = 0.299, p = 0.044). IVP monitoring and raised IVP did not correlate with the need for surgical intervention. Raised IVP was associated with neonatal morbidity and maybe neonatal mortality. A large, prospective, observational study is required to evaluate the role of IVP monitoring in ACS and its associated outcomes. III.

Sections du résumé

BACKGROUND BACKGROUND
Abdominal compartment syndrome (ACS) is a pathological increase of the intra-abdominal pressure (IAP) with dysfunction of one or more organs. There is lack of clarity in neonates regarding what intravesical pressure (IVP) value, a surrogate marker for IAP, indicates the need for intervention for ACS.
METHODS METHODS
The medical records at a Children's Hospital NICU were reviewed to identify all neonates that had IVP/s monitored over a 10-year period (2008-2017). Demographic parameters, IVPs, and important clinical outcomes were obtained. Associations between IVP monitoring and clinical outcomes were explored.
RESULTS RESULTS
Forty-six neonates had IVP monitoring, with 4 (8%) being diagnosed with ACS requiring further operative intervention. There was no significant correlation between IVP and need for surgery. There was a significant positive correlation between the maximum IVP and the need for total parenteral nutrition (rs = 0.350, p = 0.017), ventilator support (rs = 0.321, p = 0.034) and length of stay (rs = 0.362, p = 0.016) and between a diagnosis of ACS and neonatal mortality (rs = 0.299, p = 0.044).
CONCLUSIONS CONCLUSIONS
IVP monitoring and raised IVP did not correlate with the need for surgical intervention. Raised IVP was associated with neonatal morbidity and maybe neonatal mortality. A large, prospective, observational study is required to evaluate the role of IVP monitoring in ACS and its associated outcomes.
LEVEL OF EVIDENCE METHODS
III.

Identifiants

DOI: 10.1016/j.jpedsurg.2019.08.003 PMID: 31753610
pubmed: 31753610
pii: S0022-3468(19)30510-X
doi: 10.1016/j.jpedsurg.2019.08.003
pii:
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1296-1301

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Amy Hort (A)

The Department of Surgery, The Children's Hospital Westmead, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia. Electronic address: amy.hort@health.nsw.gov.au.

Himanshu Popat (H)

Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Grace Centre for Newborn Care, The Children's Hospital Westmead, Sydney, Australia.

Robert Halliday (R)

Grace Centre for Newborn Care, The Children's Hospital Westmead, Sydney, Australia.

Claire Galea (C)

Grace Centre for Newborn Care, The Children's Hospital Westmead, Sydney, Australia; Cerebral Palsy Alliance, The University of Sydney, Sydney, Australia.

Soundappan Soundappan (S)

The Department of Surgery, The Children's Hospital Westmead, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia.

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Classifications MeSH

questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Signes et symptômes digestifs › Douleur abdominale › Abdomen aigu › Abdominal compartment syndrome monitoring in...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Abdominal compartment syndrome monitoring in...
questionsmedicales.fr › Personnes › Tranches d'âge › Nourrisson › Nouveau-né › Abdominal compartment syndrome monitoring in...
questionsmedicales.fr › Malformations et maladies congénitales, héréditaires et néonatales › Maladies néonatales › Abdominal compartment syndrome monitoring in...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Syndrome des loges › Hypertension intra-abdominale › Abdominal compartment syndrome monitoring in...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Monitorage physiologique › Abdominal compartment syndrome monitoring in...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Projets pilotes › Abdominal compartment syndrome monitoring in...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Abdominal compartment syndrome monitoring in...