Abdominal compartment syndrome monitoring in neonates with an acute abdomen – A pilot, retrospective, observational study
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In brief
In brief
Retrospective study of 46 neonates with acute abdomen found that intravesical pressure monitoring did not predict need for surgical intervention in abdominal compartment syndrome. Elevated pressures correlated with increased morbidity including ventilator dependence and prolonged hospitalization, suggesting IVP may be a marker of disease severity rather than a surgical decision tool.
Written by the GCMD Library team from the article.
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
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
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
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
III.