Intra-adominal pressure as an indicant of gastrointestinal insufficiency severity in pediatrics

Abstract

The complex organization and diversity of the tasks performed creates problems in measuring the viability of the digestive system. Intestinal paresis is the most frequent companion of critical conditions. As the intestinal paresis increases, the pressure in the abdominal cavity increases. The study was performed to test the hypothesis of the relationship of intra-abdominal pressure (IAP) with manifestations of gastrointestinal insufficiency and disorders of homeostasis. The observational dynamic study included 46 children from 4 months to 7 years. Patients were monitored for up to 7 days in the intensive care unit. The criterion for intra-abdominal hypertension was the level of intra-abdominal pressure exceeding 10 mm Hg. Correlation and regression analysis was used to test the hypothesis. The level of intra-abdominal pressure was associated with a decreased volume of enteral feeding and increasing of gastric residual volume. Poor feeding tolerance was noted in the most patients with an IAP more than 10 mm Hg. A significant relation was noted between the level of IAP and the frequency of gastrointestinal bleeding. The level of IAP was significantly related with the presence of gastrointestinal insufficiency, and the number of points determined with the quantitative diagnostics sheet for gastrointestinal insufficiency. Intra-abdominal pressure had a proper sensitivity/specificity test, AUC - 0.8. The simultaneous evaluation of supplied calories and the level of IAP was accompanied by the best sensitivity/specificity indicator, AUC = 0.91.