Monitoring and Value of Intra-abdominal Pressure in Critically Ill Children in Pediatric Intensive Care Unit
Pediatric Department, Hainan Women and Children's Medical Center, Haikou 570100, China
| Abstract: | Objective: To study and test the critical comprehensive value of intra-abdominal pressure (IAP) in monitoring and treatment of PICU patients. Methods: Via monitoring the dynamic bladder pressure of 86 cases of severe children admitted to our PICU from September 2023 to December 2023, the influences of increased IAP on the respiratory function, blood flow dynamics and condition were analyzed. Symptomatic treatments were performed for the children with intra-abdominal hypertension. Results: In the routine examination of 86 PICU patients, the changes of heart rate, blood pressure, breathing and peripheral blood oxygen saturation before and after the first IAP monitoring had no significant differences in statistics (P>0.05). The pediatric critical illness score (PCIS) and urine volume in the group with high IAP were obviously lower, while the central venous pressure (CVP) and blood lactate level were obviously higher than those of the group with normal IAP (P<0.01). The correlation coefficient between IAP and CVP, blood lactate level were 0.417, 0.300, respectively (P<0.01). The correlation coefficient between IAP and PCIS, urine volume were -0.499, -0.483, respectively (P<0.01). After treatment to reduce intra-abdominal hypertension, PCIS, urine volume of the group with high IAP increased significantly, and CVP, blood lactate level decreased gradually (P<0.05 or P<0.01). Conclusions: The trans-bladder manometry method is high safety, feasible and small traumatic for the measurement of IAP. Dynamic monitoring of IAP in severe children has certain clinical value. Taking timely and effective treatment measures to reduce IAP can help to improve the condition of the children. |
| Keywords: | Intra-abdominal Pressure; Bladder Pressure; Intra-abdominal Hypertension; Pediatric Intensive Care Unit |
| DOI: | 10.57237/j.wjcm.2024.02.002 |
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Received: 4 June 2024
Accepted: 16 July 2024
Published Online: 18 July 2024
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