The prevalance of and factors associated with intra-abdominal hypertension on admission Day in critically Ill pediatric patients: A multicenter study

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 pediatr...

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Published in:Journal of critical care 2015-06, Vol.30 (3), p.584-588
Main Authors: Horoz, Ozden O., MD, Yildizdas, Dincer, MD, Asilioglu, Nazik, MD, Kendirli, Tanil, MD, Erkek, Nilgun, MD, Anil, Ayse Berna, MD, Bayrakci, Benan, MD, Koroglu, Tolga, MD, Akyildiz, Basak Nur, MD, Arslankoylu, Ali Ertug, MD, Dursun, Oguz, MD, Kesici, Selman, MD, Sevketoglu, Esra, MD, Unal, Ilker, MD
Format: Article
Language:English
Subjects:
Abdomen
Abdominal compartment syndrome
Abdominal surgery
Bladder
Blood products
Child
Confidence intervals
Conflicts of interest
Critical Care
Critical Illness
Female
Hospitalization
Humans
Hypertension
Hypothermia
Hypothermia - epidemiology
Intensive care
Intra-Abdominal Hypertension - blood
Intra-Abdominal Hypertension - epidemiology
Intra-Abdominal Hypertension - etiology
Intra-abdominal pressure
Laboratories
Lactate
Lactates - blood
Liver
Male
Medical treatment
Mortality
Oligo-anuria
Organ dysfunction
Patients
Pediatrics
Prevalence
Prospective Studies
Respiration, Artificial - statistics & numerical data
Risk factors
Sepsis
Statistical analysis
Trauma
Urination Disorders - epidemiology
Variables
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Summary: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.
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2015.01.021