Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings

TL;DR

This review discusses the causes, diagnosis, and treatment of intra-abdominal hypertension and abdominal compartment syndrome in critically ill children.

Contribution

The paper provides a focused review of pediatric IAH/ACS, emphasizing pathophysiology, risk factors, and management strategies.

Findings

Key risk factors include reduced abdominal wall compliance and fluid resuscitation.

Monitoring intra-abdominal pressure and tissue perfusion is critical for early diagnosis.

Non-surgical interventions can reduce the need for surgery in pediatric IAH/ACS.

Abstract

Intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS) is one of the rarer clinical entities in the pediatric population, carrying a high degree of morbidity and mortality. The focus of this review is on assessing pathophysiological changes of organ systems in pediatric patients with risk factors for the occurrence of IAH/ACS based on the evaluation of diagnostic modalities and therapeutic strategies.

A comprehensive literature search of indexed databases was performed, aiming to identify, review, and evaluate published articles on IAH/ACS. The search was focused on studies examining pathophysiology, risk factors, diagnostic approaches, and management strategies.

The main risk factors encompass diminished abdominal wall compliance, increased intraluminal and abdominal contents, and capillary leak/fluid resuscitation. Diagnostic tools include clinical and imaging findings, intra-abdominal pressure (IAP) monitoring, and parameters of tissue perfusion. Therapeutic strategies involve non-surgical and surgical management of IAH/ACS in pediatric patients.

Timely and continuous evaluation of IAP and parameters of tissue perfusion is crucial for the early diagnosis of IAH/ACS and implementing non-surgical procedures, reducing the need for surgical procedures. Future research should focus on the usefulness of advanced non-invasive monitoring technologies and the identification of predictors of increased IAP in the early implementation of personalized therapeutic strategies.