The Department of Surgery, The Children's Hospital Westmead, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Grace Centre for Newborn Care, The Children's Hospital Westmead, Sydney, Australia.
J Pediatr Surg. 2020 Jul;55(7):1296-1301. doi: 10.1016/j.jpedsurg.2019.08.003. Epub 2019 Nov 6.
Abdominal compartment syndrome (ACS) is a pathological increase of the intra-abdominal pressure (IAP) with dysfunction of one or more organs. There is lack of clarity in neonates regarding what intravesical pressure (IVP) value, a surrogate marker for IAP, indicates the need for intervention for ACS.
The medical records at a Children's Hospital NICU were reviewed to identify all neonates that had IVP/s monitored over a 10-year period (2008-2017). Demographic parameters, IVPs, and important clinical outcomes were obtained. Associations between IVP monitoring and clinical outcomes were explored.
Forty-six neonates had IVP monitoring, with 4 (8%) being diagnosed with ACS requiring further operative intervention. There was no significant correlation between IVP and need for surgery. There was a significant positive correlation between the maximum IVP and the need for total parenteral nutrition (rs = 0.350, p = 0.017), ventilator support (rs = 0.321, p = 0.034) and length of stay (rs = 0.362, p = 0.016) and between a diagnosis of ACS and neonatal mortality (rs = 0.299, p = 0.044).
IVP monitoring and raised IVP did not correlate with the need for surgical intervention. Raised IVP was associated with neonatal morbidity and maybe neonatal mortality. A large, prospective, observational study is required to evaluate the role of IVP monitoring in ACS and its associated outcomes.
III.
腹腔间隔室综合征（ACS）是一种腹腔内压力（IAP）病理性升高并伴有一个或多个器官功能障碍的疾病。在新生儿中，对于什么是膀胱内压（IVP）值，以及它作为 IAP 的替代标志物，需要达到什么程度才需要进行 ACS 干预，目前尚不清楚。
回顾了一家儿童医院 NICU 的病历，以确定在 10 年期间（2008-2017 年）接受 IVP/s 监测的所有新生儿。获取了人口统计学参数、IVP 和重要的临床结果。探讨了 IVP 监测与临床结果之间的关联。
46 名新生儿接受了 IVP 监测，其中 4 名（8%）被诊断为 ACS，需要进一步手术干预。IVP 与手术需求之间没有显著相关性。IVP 的最大值与全肠外营养（rs=0.350，p=0.017）、呼吸机支持（rs=0.321，p=0.034）和住院时间（rs=0.362，p=0.016）的需求以及 ACS 诊断和新生儿死亡率（rs=0.299，p=0.044）之间存在显著正相关。
IVP 监测和升高的 IVP 与手术干预的需求无关。升高的 IVP 与新生儿发病率有关，可能与新生儿死亡率有关。需要进行一项大型、前瞻性、观察性研究，以评估 IVP 监测在 ACS 及其相关结局中的作用。
III 级
