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Outcomes of children with abdominal compartment syndrome

J Chiaka Ejike, S Humbert, K Bahjri

    Acta Clinica Belgica
    |June 3, 2014
    PubMed

    Insights

    Abdominal compartment syndrome (ACS) significantly increases mortality risk in critically ill children. Intra-abdominal pressure (IAP) monitoring and PRISM scores can help identify children at risk for developing ACS.

    Area of Science:

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

    Background:

    • Abdominal compartment syndrome (ACS) is a critical condition with high mortality, yet poorly described in pediatric intensive care.
    • Understanding ACS in children is crucial for improving outcomes in critical care settings.

    Purpose of the Study:

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

    Main Methods:

    • Intra-abdominal pressures (IAP) were monitored in critically ill pediatric patients (<50 kg, mechanically ventilated, with urethral catheter) using the intra-vesical technique.
    • ACS was defined as IAP >12mmHg with new organ dysfunction.
    • Demographics, organ dysfunction measures, PICU LOS, and mortality were recorded.

    Main Results:

    • ACS occurred in 4.7% of eligible pediatric patients, with a 50% mortality rate compared to 8.2% in non-ACS patients.
    • Intra-abdominal pressure (IAP) and ACS were independent predictors of mortality.
    • Elevated IAP and a PRISM score ≥17 predicted the development of ACS.

    Conclusions:

    • Abdominal compartment syndrome (ACS) is a significant risk factor for mortality in critically ill children.
    • Intra-abdominal pressure (IAP) monitoring and PRISM scores can aid in identifying pediatric patients at risk for developing ACS.
    Abstract

    Keywords:
    abdominal compartment syndrome,children,intra-abdominal pressure,mortality,outcomes

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