Hemodynamics Assessment in Critically Ill Children with Increased Intra-Abdominal Pressure

Background : Intra-abdominal pressure (IAP) is the pressure concealed within the abdomen. IAP is a sustained increase in IAP ≥ 12 mmHg. A consensus definition from 2013 states that IAH in children is a sustained or repeated elevation in IAP greater than 10 mmHg. Aim of the study : Evaluate the prevalence of increased intra-abdominal pressure and its impact on morbidity and mortality in the pediatric intensive care unit. To assess hemodynamics in these critically ill children using vasoactive drugs. Patients and methods : This prospective study was carried out on 50 pediatric patients from 4 to 156 months (27 males and 23 females) admitted to the PICU, Tanta University Hospital. Intra-abdominal pressure of all patients was measured by the bladder method at admission and 4 hours after performing IAP decreasing techniques. Results : IAP was a significant predictor for hemodynamic instability with a cut-off value>12 mmHg. Conclusion : Elevated IAP in critically ill pediatric patients was associated with high prevalence and significant hemodynamic disturbances, including compromised cardiac output (CO), increased systemic vascular resistance (SVRI), and reduced abdominal perfusion pressure (APP).