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Ascites in infants with severe sepsis - treatment with peritoneal drainage

Andrzej Piotrowski1, Wojciech Sobala, Paweł Krajewski

  • 1Department of Anaesthesia and Intensive Care, Paediatric Hospital, Medical University of Lodz, Lodz, Poland. andrzej-oiom@wp.pl

Paediatric Anaesthesia
|November 24, 2006
PubMed

Insights

Ascites in infants can be a serious complication of sepsis, leading to respiratory issues. Continuous peritoneal drainage using an intravenous catheter is a safe and effective method to improve gas exchange in these critical patients.

Area of Science:

  • Neonatal and Pediatric Intensive Care
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Ascites in neonates and infants typically stems from cardiac failure or urinary/biliary obstruction.
  • This study investigates ascites as a complication specifically arising from sepsis in infants.

Purpose of the Study:

  • To characterize the clinical experience and outcomes of ascites developing as a complication of nosocomial sepsis in infants.
  • To evaluate the efficacy and safety of continuous peritoneal drainage for managing sepsis-induced ascites.

Main Methods:

  • Retrospective analysis of ten infants in a pediatric intensive care unit (ICU) who developed ascites during sepsis.
  • Patients received broad-spectrum antibiotics, blood transfusions, catecholamines, and intravenous immunoglobulin.
  • Continuous peritoneal drainage was implemented using an intravascular catheter, and its impact on gas exchange was assessed.

Main Results:

  • Ascites developed a median of 13.5 days after sepsis onset, significantly compromising gas exchange.
  • Continuous peritoneal drainage yielded a mean of 44.7 ml/kg/day of fluid and improved ventilator settings within 24 hours.
  • Six out of ten infants survived, with no severe complications reported from the drainage procedure.

Conclusions:

  • Sepsis-induced ascites in infants can lead to severe respiratory compromise.
  • Continuous drainage of ascitic fluid via an intravenous catheter is a relatively safe and effective intervention to improve respiratory function.
Abstract

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