Ozden O Horoz1, Dincer Yildizdas2, Nazik Asilioglu3, Tanil Kendirli4, Nilgun Erkek5, Ayse Berna Anil6, Benan Bayrakci7, Tolga Koroglu8, Basak Nur Akyildiz9, Ali Ertug Arslankoylu10, Oguz Dursun11, Selman Kesici7, Esra Sevketoglu12, Ilker Unal13. 1. Cukurova University, School of Medicine, Department of Pediatrics, division of Pediatric Intensive Care Unit, Adana, Turkey. Electronic address: oozgurhoroz@yahoo.com. 2. Cukurova University, School of Medicine, Department of Pediatrics, division of Pediatric Intensive Care Unit, Adana, Turkey. 3. Ondokuz Mayıs University, School of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care Unit, Samsun, Turkey. 4. Ankara University, School of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care Unit, Ankara, Turkey. 5. Marmara University, School of Medicine, Department of Pediatrics, division of Pediatric Emergency Department, Istanbul, Turkey. 6. Tepecik Training of Research Hospital, Pediatric Intensive Care Unit, Izmir, Turkey. 7. Hacettepe University, School of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care Unit, Ankara, Turkey. 8. Dokuz Eylul University, School of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care Unit, Izmir, Turkey. 9. Erciyes University, School of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care Unit, Kayseri, Turkey. 10. Mersin University, School of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care Unit, Mersin, Turkey. 11. Akdeniz University, School of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care Unit, Antalya, Turkey. 12. Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Pediatric Intensive Care Unit, Istanbul, Turkey. 13. Cukurova University, School of Medicine, Department of Biostatistics, Adana, Turkey.
Abstract
PURPOSE: To investigate admission prevalence of intraabdominal hypertension (IAH) and to determine clinical and laboratory characteristics on admission day associated with IAH in critically ill pediatric patients. MATERIALS AND METHODS: One hundred thirty newly admitted critically ill pediatric patients were included. Intra-abdominal pressure (IAP) was measured 4 times (every 6 hours) with the bladder pressure method. Data included the demographics, diagnostic category, pediatric logistic organ dysfunction score and pediatric risk of mortality score II, clinical concomitant factors, and conditions potentially associated with increased intra-abdominal pressure. RESULTS: Seventy patients (56.1%) had a normal IAP (≤10 mmHg, mean IAP [mmHg] 7.18 ± 1.85), while 60 patients (43.9%) had IAP >10 mmHg (mean IAP [mmHg] 15.46 ± 5.21). Hypothermia frequency, lactate levels, number of patients with oligo-anuria, and mechanical ventilation requirement were higher among patients with IAH compared to patients without IAH (both, P< .05). Hypothermia (OR, 3.899; 95% CI, 1.305-11.655; P< .03) and lactate levels (OR, 1.283 for each mmol/L increase; 95% CI, 1.138-1.447; P< .001) were only significantly associated with IAH. CONCLUSIONS: Intra-abdominal hypertension seems to affect nearly half of newly admitted critically ill pediatric patients. Lactate level and the presence of hypothermia seem to be the independent predictors of the presence of IAH.
PURPOSE: To investigate admission prevalence of intraabdominal hypertension (IAH) and to determine clinical and laboratory characteristics on admission day associated with IAH in critically ill pediatric patients. MATERIALS AND METHODS: One hundred thirty newly admitted critically ill pediatric patients were included. Intra-abdominal pressure (IAP) was measured 4 times (every 6 hours) with the bladder pressure method. Data included the demographics, diagnostic category, pediatric logistic organ dysfunction score and pediatric risk of mortality score II, clinical concomitant factors, and conditions potentially associated with increased intra-abdominal pressure. RESULTS: Seventy patients (56.1%) had a normal IAP (≤10 mmHg, mean IAP [mmHg] 7.18 ± 1.85), while 60 patients (43.9%) had IAP >10 mmHg (mean IAP [mmHg] 15.46 ± 5.21). Hypothermia frequency, lactate levels, number of patients with oligo-anuria, and mechanical ventilation requirement were higher among patients with IAH compared to patients without IAH (both, P< .05). Hypothermia (OR, 3.899; 95% CI, 1.305-11.655; P< .03) and lactate levels (OR, 1.283 for each mmol/L increase; 95% CI, 1.138-1.447; P< .001) were only significantly associated with IAH. CONCLUSIONS:Intra-abdominal hypertension seems to affect nearly half of newly admitted critically ill pediatric patients. Lactate level and the presence of hypothermia seem to be the independent predictors of the presence of IAH.
Authors: Letícia G T Silveira; Isabela C Brocca; Erika S Moraes; Marcelo B Brandão; Roberto J N Nogueira; Tiago Henrique de Souza Journal: J Pediatr (Rio J) Date: 2020-12-21 Impact factor: 2.990