Incidence, Risk Factors, and Prognosis of Intra-Abdominal Hypertension in Critically Ill Children

Thabet, Farah; Bougmiza, Iheb; Chehab, May; Bafaqih, Hind; AlMohaimeed, Sulaiman A.; Malbrain, Manu L N G

doi:10.1177/0885066615583645

Cited by 36 publications

(38 citation statements)

References 23 publications

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“…It can be mimicked or concealed by generalized edema, ascites, a full bladder, peritoneal dialysis, and swallowing air with hand ventilation or non-invasive ventilation, if there is inadequate gastric decompression. Nevertheless, abdominal girth can be objectively measured and assessed [39], although there is no validated threshold of distention that is significant (in absolute value or percentage). Like many other PICU assessment parameters, the absolute value (abdominal girth if measured in a consistent way and place) can be used as a trend over time.…”

Section: Abdominal Pain And/or Distentionmentioning

confidence: 99%

“…Like many other PICU assessment parameters, the absolute value (abdominal girth if measured in a consistent way and place) can be used as a trend over time. Intra-abdominal pressure, estimated by urinary bladder pressure monitoring through the urinary catheter [39], is not a sign of feeding intolerance but rather a sign of Brisk to feed^if elevated. Indeed, high intraabdominal pressure is the consequence of severe ascites or intra-abdominal compression.…”

Section: Abdominal Pain And/or Distentionmentioning

confidence: 99%

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A review of feeding intolerance in critically ill children

Tume

Valla

2018

Eur J Pediatr

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Ensuring optimal nutrition is vital in critically ill children and enteral feeding is the main route of delivery in intensive care. Feeding intolerance is the most commonly cited reason amongst pediatric intensive care unit healthcare professionals for stopping or withholding enteral nutrition, yet the definition for this remains inconsistent, nebulous, and entirely arbitrary. Not only does this pose problems clinically, but research in this field frequently uses feeding intolerance as an endpoint and the heterogeneity in this definition makes the comparison of studies difficult and meta-analysis impossible. We reviewed the use of, and definitions of, the term feed intolerance in pediatric intensive care research papers in the last 20 years. Gastric residual volume remains the most common factor used to define feed intolerance, despite the lack of evidence for this. Healthcare professionals would benefit from further education to improve their awareness of the limitations of the markers to define feeding intolerance, and the international PICU community needs to agree a consistent definition of this phenomenon to improve consistency in both practice and research.Conclusion: This paper will provide a narrative review of the definitions of, evidence for, and markers of feeding intolerance in critically ill children.

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Section: Abdominal Pain And/or Distentionmentioning

confidence: 99%

Section: Abdominal Pain And/or Distentionmentioning

confidence: 99%

A review of feeding intolerance in critically ill children

Tume

Valla

2018

Eur J Pediatr

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“…In children, IAH is defined as an IAP ≥ 10 mm Hg (grade I, 10‐12 mm Hg; grade II, 13‐15; grade III, 16‐19 mm Hg; grade IV ≥ 20 mm Hg) . IAH affects 15%‐45% of PICU patients . Excessively high IAP that interferes with vascular inflow and venous return and thereby endangers the viability of abdominal organs constitutes a condition known as abdominal compartment syndrome, which is diagnosed in 0.7%‐4.7% of children treated in PICUs and associated with very high mortality (40%‐80%) …”

Section: Introductionmentioning

confidence: 99%

“…The clinical relevance of IAH and abdominal compartment syndrome in intensive care patients and their impacts on morbidity and mortality have come into focus in recent years . This study aimed to analyze longitudinal IAP measurements in children who underwent LTX.…”

Section: Introductionmentioning

confidence: 99%

“…14 IAH affects 15%-45% of PICU patients. 15,16 Excessively high IAP that interferes with vascular inflow and venous return and thereby endangers the viability of abdominal organs constitutes a condition known as abdominal compartment syndrome, which is diagnosed in 0.7%-4.7% of children treated in PICUs and associated with very high mortality (40%-80%). [17][18][19][20] The clinical relevance of IAH and abdominal compartment syndrome in intensive care patients and their impacts on morbidity and mortality have come into focus in recent years.…”

Section: Introductionmentioning

confidence: 99%

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Monitoring intra‐abdominal pressure after liver transplantation in children

Deindl

Wagner

Herden

et al. 2019

Pediatric Transplantation

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IAH after LTX can impair perfusion and threaten graft viability. This study aimed to assess the feasibility of longitudinal IAP measurements as an IAH screening method in children after LTX. A cohort of 23 children with a mean age (range) 3.1 (3 months–14 years) who underwent LTX between May 2017 and February 2018 were evaluated retrospectively. Longitudinal IAP measurements were compared to bedside Doppler US monitoring data. In total, 425 IAP measurements and 257 US examinations were performed. The mean ± SD (range) time expenditure for IAP measurement was 1.9 ± 0.4 (0.5‐3.2) minutes. The mean post‐operative IAP was 7.9 ± 3.6 (1‐25) mm Hg. IAH (IAP ≥ 10 mm Hg) was noted in 102 (24%) of 257 measurements. Agitation had a significant impact on IAP (estimate: 9.3 mm Hg, CI: 6.72‐11.97, P < .01). In patients with TAC, IAP was increased (6.7 ± 2.1 vs 8.7 ± 3.1 mm Hg, P = .02) while peak portal venous velocities decreased (38 ± 27 vs 26 ± 22 cm/s, P = .03) after patch reduction. An abdominal compartment syndrome with severely impaired vascular flow was noted in one patient. Episodes of elevated IAP were noted in a large proportion of patients, underscoring the need for IAP monitoring in pediatric liver transplant recipients. The safety and low time expenditure associated with IAP measurement could be included easily into standard nursing procedures for these patients.

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Pediatric Critical Care

Garvey¹,

Egan²

2018

Surgical Critical Care and Emergency Surgery

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Incidence, Risk Factors, and Prognosis of Intra-Abdominal Hypertension in Critically Ill Children

Cited by 36 publications

References 23 publications

A review of feeding intolerance in critically ill children

A review of feeding intolerance in critically ill children

Monitoring intra‐abdominal pressure after liver transplantation in children

Pediatric Critical Care

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