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| The risk factors and prognosis of intra-abdominal hypertension in critically ill children |
| Liang Yu-jian, Li Su-ping, Tao Shao-hua, Huang Hui-min, Pei Yu-xin, Tang Wen |
| Pediatric Intensive Care Unit, the First Affiliated Hospital of Zhongshan University, Guangzhou 510080, China |
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Abstract Objective: To investigate the risk factors and prognosis of intra-abdominal hypertension (IAH) in critically ill children. Methods: Prospective longitudinal observational study was conducted in two tertiary care university teaching hospital from December 2013 to June 2016. All children consecutively admitted to the PICU, staying more than 24 hours, age ≤14 years and requiring bladder catheterization, were included in the study. The intra-abdominal pressure(IAP) was measured every 8 hours through a bladder catheter until discharge or removal of the catheter. On admission, demographic data and risk factors for IAH were studied. Risk factors were analyzed by multiple Logistic regression models. Prognosis was assessed by Kaplan-Meier curves. Results: Of the 458 patients, 180 (39.3%) had IAH (IAP＞10 mm Hg) during PICU stay. The independent risk factors associated with IAH were abdominal neoplasms (OR 9.7, 95% CI 1.1～93.8,P=0.04), lactic acid level (OR 2.4, 95% CI 1.1～5.3,P=0.03) and non-abdominal diseases (OR 0.1, 95% CI 0.1～0.2,P＜0.001). Obesity, MV and PEEP were not significant factors affecting IAH in children. The duration of MV was not significantly longer in patients with IAH vs. patients without IAH (P＞0.05). Length of the hospital stay (P=0.02) and 60-day mortality rate (P＜0.01) was significantly higher in the IAH group than in the non-IAH group. The IAH and non-IAH survival curves also differed significantly at 60-day (P＜0.001). Conclusion: IAH does have high occurrence and mortality rate in critically ill children. Abdominal neoplasms and lactic acid level are independent risk factors of developing IAH. Children with IAH have higher mortality rate and length of the hospital stay.
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Received: 30 August 2017
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Corresponding Authors:
Tang Wen， E-mail:tangwen@mail.sysu.edu.cn
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