Intra-abdominal hypertension and abdominal compartment syndrome in pediatrics. A review

Farah Chedly Thabet1, Janeth Chiaka Ejike2

  • 1Pediatric Intensive Care Unit, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Insights

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are serious conditions in critically ill children, often under-diagnosed. Early recognition and management of IAH and ACS are vital for improving outcomes.

Area of Science:

  • Pediatric Critical Care Medicine
  • Gastroenterology
  • Surgical Critical Care

Background:

  • Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are associated with significant morbidity and mortality.
  • These conditions are well-documented in adult critically ill patients.
  • Pediatric IAH and ACS are under-recognized by healthcare providers despite similar prognostic impacts.

Purpose of the Study:

  • To consolidate pediatric intensivists' understanding of IAH and ACS pathophysiology, definition, incidence, monitoring, and management.
  • To highlight pediatric-specific characteristics of IAH and ACS.

Main Methods:

  • A narrative review of the medical literature.
  • Systematic search of PubMed for English-language articles published between January 1990 and August 2016.
  • Keywords included "intra-abdominal hypertension and child/pediatrics" and "abdominal compartment syndrome and child/pediatrics".

Main Results:

  • IAH incidence in children is reported at 13%, while ACS incidence is 0.6% to 10%.
  • IAH and ACS contribute to pathophysiological disturbances, increased morbidity, and mortality in critically ill children.
  • Despite similar prognostic impact to adults, these conditions remain under-diagnosed in pediatric populations.

Conclusions:

  • IAH and ACS are frequently encountered in critically ill children, leading to increased morbidity and mortality.
  • Timely recognition, prevention, and management are crucial for improving outcomes.
  • Enhanced awareness and diagnostic capabilities are needed for pediatric IAH and ACS.
Abstract

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