The relationship of abdominal perfusion pressure with mortality in critically ill pediatric patients
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In brief
In brief
Prospective cohort study of 35 critically ill children demonstrates that decreased minimum abdominal perfusion pressure (APP) is associated with increased mortality risk in patients with intra-abdominal hypertension. This represents the first pediatric data on APP's clinical utility as a prognostic marker in the PICU setting.
Written by the GCMD Library team from the article.
Purpose
To the best of our knowledge, in the literature, there is no data regarding clinical utility of the abdominal perfusion pressure (APP) in critically ill children. Thus, in the present study, we aimed to investigate the clinical utility of APP in predicting of survival in critically ill children with IAH.
Design
A prospective cohort study of patients between 1 month to 18 years who had risk for intra-abdominal hypertension from June 2013 to January 2014.
Setting
Pediatric intensive care unit (PICU) at a tertiary university hospital.
Patients
Thirty-five (16 female) PICU patients who had risk for the development of IAH were included. Serial intraabdominal pressure (IAP) and mean arterial pressure (MAP) measurements were performed. Abdominal perfusion pressure was calculated using the formula (MAP-IAP).
Measurements and Main Results
Overall mortality rate was 49% (n = 17). The mortality rate in patients with IAP mean ≥10 mmHg (n = 27, 77%) was 55% (n = 15), while 53% (n = 16) in patients with IAP max ≥10 mmHg (n = 30, 86%) and 47% (n = 7) in patients with IAP min ≥ 10 mmHg (n = 15, 43%). Overall mean APP was 58 ± 20 mmHg. Logistic regression analysis revealed that decrease in minAPP was associated with increased risk for mortality (Odds ratio for each 1 mmHg decrease in APP was 1.052 [CI 95%, 1.006–1.100], p