Factors affecting intra-abdominal pressure in surgical children

Abstract

Aims: The deleterious consequences of elevated intra-abdominal pressure and abdominal compartment syndrome have been well documented in both animal models and clinical studies. However, there have been no large series to determine intra-abdominal pressure in surgical children. The purpose of this study is to attempt to identify factors that predict variation in intra-abdominal pressure in hospitalized (surgical) children. Methods: All patients who are admitted to paediatric surgical services and requiring a transurethral bladder catheter (Foley's) were enrolled in this study. Informed consent was obtained for the study. Intra-abdominal pressure was indirectly determined through the measurement of bladder pressure via a transurethral bladder (Foley) catheter - based on the procedure described by Kron et al. Data obtained for each patient included demographics (i.e., age, gender, height, and weight) and IAP. In addition the reasons for hospitalization and bladder catheterization, previous and current abdominal surgical history, and any associated illness will be noted. The data was then tabulated and summarized. Results: A total of 23 children were prospectively enrolled between July 2002 and January 2003. There were 11 boys and 12 girls with a mean age of 6 years (range 0.25-17 years). Average weight and height were 22.3 kg and 1.06 m respectively. Average body mass index was 16.8 kg/m 2 (range 12.4-32. 6 kg/m 2). Mean intra-abdominal pressure was 5.5 mm Hg (range 1.8-15. 4 mm Hg). Conclusions: Age, body mass index and current status of surgical field were determined as significant factors affecting a change in intra-abdominal pressure. From a multiple regression analysis, age (p = 0.007), body mass index (p = 0.011) and current status of surgical field (p = 0.001) were determined as significant factors affecting a change in intra-abdominal pressure.