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Outcomes of children with abdominal compartment syndrome

J Chiaka Ejike1, S Humbert, K Bahjri

  • 1Department of Pediatrics, School of Medicine, Loma Linda University, School of Medicine Loma Linda, California 92354, USA. jejike@ahs.llumc.edu

Acta Clinica Belgica
|May 2, 2007
PubMed

Insights

Abdominal compartment syndrome (ACS) significantly increases mortality in critically ill children. Intra-abdominal pressure (IAP) monitoring and PRISM scores can help predict ACS development and patient outcomes.

Area of Science:

  • Pediatric Critical Care Medicine
  • Intensive Care Unit Management
  • Abdominal Compartment Syndrome Research

Background:

  • Abdominal compartment syndrome (ACS) is a critical condition with high mortality across intensive care settings.
  • ACS is under-described in pediatric populations, necessitating further investigation.

Purpose of the Study:

  • To determine the incidence of ACS in critically ill children.
  • To evaluate the impact of ACS on pediatric intensive care unit (PICU) mortality and length of stay (LOS).
  • To identify predictors for mortality and ACS development in this cohort.

Main Methods:

  • Intra-abdominal pressures (IAP) were monitored using the intra-vesical technique in mechanically ventilated pediatric patients (<50 kg) with urethral catheters.
  • ACS was defined as IAP >12mmHg with new organ dysfunction.
  • Data collected included demographics, organ dysfunction markers, PICU LOS, and mortality.

Main Results:

  • ACS occurred in 4.7% of eligible patients (14/294).
  • Mortality was substantially higher in patients with ACS (50%) compared to those without (8.2%).
  • Elevated IAP and ACS were independent predictors of mortality; IAP and PRISM score >17 predicted ACS development.

Conclusions:

  • ACS presents a significant clinical challenge, elevating mortality risk in critically ill children.
  • Intra-abdominal pressure (IAP) and Pediatric Risk of Mortality (PRISM) scores are valuable tools for identifying children at risk of developing ACS.
Abstract

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