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The relationship of abdominal perfusion pressure with mortality in critically ill pediatric patients

Ozden Ozgur Horoz1, Dincer Yildizdas1, Yusuf Sari1

  • 1Department of Pediatric Intensive Care Unıt, Çukurova University, School of Medicine, Adana, Turkey.

Journal of Pediatric Surgery
|January 15, 2019
PubMed

Insights

Abdominal perfusion pressure (APP) can predict mortality in critically ill children with intra-abdominal hypertension (IAH). Lower APP levels indicate a higher risk of death, suggesting APP is a valuable clinical tool.

Area of Science:

  • Pediatric Critical Care Medicine
  • Hemodynamic Monitoring
  • Intra-abdominal Hypertension (IAH) Management

Background:

  • Limited data exists on the clinical utility of abdominal perfusion pressure (APP) in critically ill children.
  • Intra-abdominal hypertension (IAH) is a serious condition in critically ill pediatric patients, associated with increased morbidity and mortality.

Purpose of the Study:

  • To investigate the clinical utility of abdominal perfusion pressure (APP) in predicting survival in critically ill children with IAH.
  • To establish APP as a potential prognostic marker in pediatric intensive care.

Main Methods:

  • Prospective cohort study including 35 pediatric patients (1 month to 18 years) at risk for IAH.
  • Serial measurements of intra-abdominal pressure (IAP) and mean arterial pressure (MAP) were performed.
  • Abdominal perfusion pressure (APP) was calculated as MAP-IAP.

Main Results:

  • Overall mortality rate was 49%.
  • A decrease in minimum APP was significantly associated with an increased risk for mortality (OR 1.052 per 1 mmHg decrease, p<0.05).
  • Receiver operating characteristic (ROC) curve analysis showed an area under the curve of 0.765 for minAPP in predicting mortality, with an optimal cut-off of 53 mmHg.

Conclusions:

  • Abdominal perfusion pressure (APP) appears to be a useful tool for predicting mortality in critically ill children with IAH.
  • Interventions aimed at improving APP may lead to better outcomes in this patient population.
Abstract

Keywords:
Abdominal perfusion pressureMortalityPediatric patients

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