Intra-abdominal hypertension in neonates following congenital diaphragmatic hernia repair: Correlation with early postoperative respiratory and gastrointestinal outcomes
| Autor: | Anand Sanmugam, Conjeevaram Rajendrarao Thambidorai, Srihari Singaravel, Chin Seng Gan, Justin Wang, Shireen Anne Nah, Elango Thambusamy |
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| Rok vydání: | 2021 |
| Předmět: |
business.industry
Incidence (epidemiology) Respiratory System Infant Newborn Malaysia Congenital diaphragmatic hernia Abdominal Cavity General Medicine Abdominal cavity medicine.disease medicine.anatomical_structure Anesthesia Pediatrics Perinatology and Child Health Breathing Medicine Humans Surgery In patient Respiratory system Intra-Abdominal Hypertension business Gastrointestinal function Hernias Diaphragmatic Congenital |
| Zdroj: | Journal of pediatric surgery. 57(2) |
| ISSN: | 1531-5037 |
| Popis: | Increased intra-abdominal pressure (IAP) is seen in patients after congenital diaphragmatic hernia (CDH) repair owing to reduction of thoracic contents into the relatively smaller abdominal cavity. In infants, IAP ≥11 mmHg is considered intra-abdominal hypertension (IAH). We aim to determine the incidence of IAH and its relationship with duration of ventilatory support, and gastrointestinal function post CDH repair.We prospectively recruited all neonates who had CDH repair in four hospitals in Malaysia from June 2018 to October 2020. Intra vesical pressure was used as a proxy for IAP and was measured for 5 consecutive days post surgery. The daily median value was used for analysis. We categorized IAP as11 mmHg (no IAH), 11-15 mmHg (IAH), and15 mmHg (severe IAH). Incidence of IAH, its effects on the duration of ventilatory support, and gastrointestinal function were studied.There were 24 neonates included in this study. They were operated between day 1 and 6 of life (median: 4 days old). IAH was detected within the first 3 days post surgery, with 83% occurring on day one. Those requiring ventilatory support for more than 3 days contributed the largest proportion of IAH (n = 17, 71%). There was strong correlation between days of IAH and duration of ventilation (p 0.001, r = 0.70). There was moderate correlation between days of IAH and duration taken to achieve full enteral feeding (p 0.005, r = 0.70).IAP measurement is a safe and useful adjunct in post CDH monitoring and in predicting ventilatory support requirements and the time needed to establish feeding. |
| Databáze: | OpenAIRE |
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