Year 2017 Vol. 25 No 6

REVIEWS

D.A. MOROZOV 1, O.L. MOROZOVA 1, S.A. KLYUEV 2, I.A. BUDNIK 1, L.D. MALTSEVA 1, K.D. MOROZOV 1

INTRA-ABDOMINAL HYPERTENSION SYNDROME IN CHILDREN

FSAEI HE I.M. Sechenov First Moscow State Medical University MOH Russian Federation (Sechenov University) 1,
FSAE National Scientific Center of Children's Health of the Ministry of Health of Russia2, Moscow,
The Russian Federation

Intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS) are diagnosed in every third critically ill child and lethality in the syndrome of intra-abdominal hypertension (SIAH) is observed in more than half of children. The World Society of the Abdominal Compartment Syndrome (WSACS) consensus definitions and practical guidelines for diagnosis and management of IAH/ACS do not account for age-dependent anatomical and physiological characteristics of pediatric patients and are often ignored by health care professionals. Intra-abdominal pressure measurement is performed in less than half of critically ill patients. When applied in children, currently standard approach to diagnosis and treatment of IAH/ACS delivers unsatisfactory results. Timely abdominal decompression is mandatory for effective prevention of multiple organ failure and poor outcome. This article reviews the most common causes and risk factors, associated with intra-abdominal hypertension in children of different age groups; it discusses the pathophysiology of ACS, summarizes different techniques for intra-abdominal pressure measurement, overviews recent advances in assessment of target organ damage using instrumental and molecular diagnostic techniques, and highlights new treatment options in this patient population.

Keywords: intra-abdominal hypertension, abdominal compartment syndrome, multiple organ failure, congenital malformations, biomarkers of renal damage, monitoring, child
p. 621-631 of the original issue
References
  1. Kirkpatrick AW, Roberts DJ, De Waele J, Jaeschke R, Malbrain ML, De Keulenaer B, et al.Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med. 2013 Jul;39(7):1190-206. doi: 10.1007/s00134-013-2906-z.
  2. Kaussen T, Steinau G, Srinivasan PK, Otto J, Sasse M, Staudt F, et al. Recognition and management of abdominal compartment syndrome among German pediatric intensivists: results of a national survey. Ann Intensive Care. 2012 Jul 5;2(Suppl 1):S8. doi: 10.1186/2110-5820-2-S1-S7.
  3. Oda J, Ueyama M, Yamashita K, Inoue T, Noborio M, Ode Y, et al. Hypertonic lactated saline resuscitation reduces the risk of abdominal compartment syndrome in severely burned patients. J Trauma. 2006 Jan;60(1):64-71.
  4. Ure BM, Suempelmann R, Metzelder MM, Kuebler J. Physiological responses to endoscopic surgery in children. Semin Pediatr Surg. 2007 Nov;16(4):217-23.
  5. Sepbaeva AD, Geras’kin AV, Kucherov II, Zhirkova IV, Tepliakova OV, Khamatkhanova EM, i dr. Vliianie povyshennogo vnutribriushnogo davleniia na funktsiiu dykhaniia i gemodinamiku pri pervichnoi plastike perednei briushnoi stenki u novorozhdennykh detei s gastroshizisom i omfalotsele [Influence of increased intra-abdominal pressure on respiratory function and hemodynamics in primary abdominal wall plasty in newborns with gastroschisis and omphalocele]. Det Khirurgiia. 2009;(3):39-41.
  6. Ozbey H. Use of sterile adhesive film and polypropylene mesh in the construction of a temporary silo in the treatment of omphalocele. Surg Today. 2005;35(8):700-2.
  7. Goldkrand JW, Causey TN, Hull EE. The changing face of gastroschisis and omphalocele in southeast Georgia. J Matern Fetal Neonatal Med. 2004 May;15(5):331-35.
  8. Risby K, Jakobsen MS, Qvist N. Congenital Abdominal Wall Defects: Staged closure by Dual Mesh. J Neonatal Surg. 2016 Jan-Mar; 5(1):2.
  9. Kozlov YA, Novozhilov VA, Podkamenev AV, Kovalev VM, Makhov AN, Kupriakov SO. Minimal’no invazivnoe lechenie gastroshizisa [Minimally invasive treatment of gastroschisis]. Det Khirurgiia. 2005;(2):10-11.
  10. Plokhikh D.A. Rezul’taty issledovaniia fiziologicheskikh pokazatelei vnutribriushnogo davleniia u novorozhdennykh detei [Results of the study of physiological indicators of intra-abdominal pressure in newborns] Mat’ i Ditia v Kuzbasse. 2010;(2):30-33.
  11. Mandal KC, Halder P, Barman S, Kumar R, Mukhopadhyay B, Shukla RM. Intragastric pressure: Useful indicator in the management of congenital diaphragmatic hernia. J Indian Assoc Pediatr Surg. 2016 Oct-Dec;21(4):175-77. doi: 10.4103/0971-9261.186547.
  12. Shcherbina VI, Mashkov AE, Tsuman VG, Tarasova OV, Semilov EA, Filiushkin YI. Lechenie nesostoiatel’nosti anastamoza i ego stenozirovaniia posle ezofagoplastiki u novorozhdennykh s atreziei pishchevoda [Treatment of anastomosis failure and its stenosis after esophagoplasty in neonates with esophageal atresia] Det Khirurgiia. 2008;(6):21-24.
  13. Chung PH, Wong KK, Lan LC, Tam PK. Abdominal compartment syndrome after open biopsy in a child with bilateral Wilms’ tumour. Hong Kong Med J. 2009 Apr;15(2):136-38.
  14. Zani A, Eaton S, Puri P, Rintala R, Lukac M, Bagolan P, et al. International survey on the management of necrotizing enterocolitis. Eur J Pediatr Surg. 2015 Feb;25(1):27-33. doi: 10.1055/s-0034-1387942.
  15. Tanriverdi S, Koroglu O, Uygur O, Celik A, Dulger F, Yalaz M, et al. Serial intravesical pressure measurements can predict the presence and the severity of necrotizing enterocolitis. Eur J Pediatr Surg. 2013 Jun;23(3):243-48. doi: 10.1055/s-0032-1329706.
  16. Liang YJ, Huang HM, Yang HL, Xu LL, Zhang LD, Li SP, et al. Controlled peritoneal drainage improves survival in children with abdominal compartment syndrome. Ital J Pediatr. 2015;41:29. doi: 10.1186/s13052-015-0134-6.
  17. Panagiotis H, Panagiotis D, Nikolaos A, Ion B. Abdominal compartment syndrome post-late Bochdalek hernia repair: A case report. Cases J. 2008;1:199. doi: 10.1186/1757-1626-1-199.
  18. Gain IuM, Alekseev SA, Bogdan VG. Sindrom abdominal’noi kompressii v khirurgii [Syndrome of abdominal compression in surgery]. Bel Med Zhurn. 2004;(3):34-37.
  19. Libório A.B., Branco KMPC, Torres de Melo Bezerra C. Acute kidney injury in neonates: from urine output to new biomarkers. Biomed Res Int. 2014;(2014): Article ID 6015. 8 ð. doi: 10.1155/2014/601568.
  20. Tuktamyshev V.S., Kuchumov A.G., Niashin Iu.I., Samartsev V.A., Kasatova E.Iu. Vnutribriushnoe davlenie cheloveka [Human intra-abdominal pressure]. Ros Zhurn Biomekhaniki. 2013;17(1):22-31.
  21. Ricci Z, Ronco C. Neonatal RIFLE. Nephrol Dial Transplant. 2013 Sep;28(9):2211-14. doi: 10.1093/ndt/gft074.
  22. Malbrain ML, Chiumello D, Pelosi P, Bihari D, Innes R, Ranieri VM, et al. Incidence and prognosis of intraabdominal hypertension in a mixed population of critically ill patients: a multiple-center epidemiological study. Crit Care Med. 2005 Feb;33(2):315-22.
  23. Meldrum DR, Moore FA, Moore EE, Franciose RJ, Sauaia A, Burch JM. Prospective characterization and selective management of the abdominal compartment syndrome. Am J Surg. 1997 Dec;174(6):667-72; discussion 672-3.
  24. Singhal J, Shanbag P. Measurement of Intra-abdominal Pressure in Critically-ill Children. J Clin Diagn Res. 2014 Dec; 8(12): PC06-PC07. doi: 10.7860/JCDR/2014/10435.5345.
  25. Cullen DJ, Coyle JP, Teplick R, Long MC. Cardiovascular, pulmonary, and renal effects of massively increased intra-abdominal pressure in critically ill patients. Crit Care Med. 1989 Feb;17(2):118-21.
  26. Morozov DA, Morozova OL, Tsyplakov AA, Mel’nikova IA. Povrezhdenie pochek u novorozhdennykh s sindromom intraabdominal’noi gipertenzii [Kidney damage in newborns with intra-abdominal hypertension syndrome]. Vestn RAMN. 2015;(6):704-9.
  27. Davis PJ, Koottayi S, Taylor A, Butt WW. Comparison of indirect methods of measuring intra-abdominal pressure in children. Intensive Care Med. 2005 Mar;31(3):471-75.
  28. Diaz FJ, Fernandez Sein A, Gotay F. Identification and management of Abdominal Compartment Syndrome in the Pediatric Intensive Care Unit. PR Health Sci J. 2006 Mar;25(1):17-22.
  29. Doty JM, Saggi BH, Blocher CR, Fakhry I, Gehr T, et al. Effects of increased renal parenchymal pressure on renal function. J Trauma. 2000 May;48(5):874-77.
  30. Cheatham ML, Malbrain ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, et al. Results from the International Conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. II. Recommendations. Intensive Care Med. 2007 Jun;33(6):951-62.
  31. Tiwari A, Myint F, Hamilton G. Recognition and management of abdominal compartment syndrome in the United Kingdom. Intensive Care Med. 2006 Jun;32(6):906-9.
  32. McGuigan RM, Mullenix PS, Vegunta R, Pearl RH, Sawin R, Azarow KS. Splanchnic perfusion pressure: a better predictor of safe primary closure than intraabdominal pressure in neonatal gastroschisis. J Pediatr Surg. 2006 May;41(5):901-4.
  33. Ejike JC, Mathur M, Moores DC. Abdominal compartment syndrome: focus on the children. Am Surg. 2011 Jul;77(Suppl 1):S72-77.
  34. Suominen PK, Pakarinen MP, Rautiainen P, Mattila I, Sairanen H. Comparison of direct and intravesical measurement of intraabdominal pressure in children. J Pediatr Surg. 2006 Aug;41(8):1381-85.
  35. Ejike JC, Mathur M. Abdominal decompression in children. Crit Care Res Pract. 2012;2012:180797. doi: 10.1155/2012/180797.
  36. Macedo E, Malhotra R, Claure-Del Granado R, Fedullo P, Mehta RL. Defining urine output criterion for acute kidney injury in critically ill patients. Nephrol Dial Transplant. 2011 Feb;26(2):509-15. doi: 10.1093/ndt/gfq332.
  37. Genovese F, Manresa AA, Leeming DJ, Karsdal MA, Boor P. The extracellular matrix in the kidney: a source of novel non-invasive biomarkers of kidney fibrosis? Fibrogenesis Tissue Repair. 2014 Mar 28;7(1):4. doi: 10.1186/1755-1536-7-4.
  38. de Geus HR, Fortrie G, Betjes MG, van Schaik RH, Groeneveld AB. Time of injury affects urinary biomarker predictive values for acute kidney injury in critically ill, non-septic patients. BMC Nephrol. 2013;14:273. doi: 10.1186/1471-2369-14-273.
  39. Bihorac A, Baslanti TO, Cuenca AG, Hobson CE, Ang D, Efron PA, Maier RV, Moore FA, Moldawer LL. Acute kidney injury is associated with early cytokine changes after trauma. J Trauma Acute Care Surg. 2013 Apr;74(4):1005-13. doi: 10.1097/TA.0b013e31828586ec.
  40. Mao S, Huang S. The signaling pathway of hypoxia inducible factor and its role in renal diseases. J Recept Signal Transduct Res. 2013 Dec;33(6):344-8. doi: 10.3109/10799893.2013.830130.
  41. Morozov DA, Morozova OL, Tsyplakov AA, Zakharova NB, Budnik IA. Molekuliarnye markery povrezhdeniia pochek u novorozhdennykh s sindromom intraabdominal’noi gipertenzii [Molecular markers of kidney damage in newborns with intra-abdominal hypertension syndrome]. Pediatriia Zhurn im GN Speranskogo. 2015;94(3):13-19.
  42. Vaidya VS, Ford GM, Waikar SS, Wang Y, Clement MB, Ramirez V, et al. A rapid urine test for early detection of kidney injury. Kidney Int. 2009 Jul;76(1):108-14. doi: 10.1038/ki.2009.96.
  43. Peng H, Mao Y, Fu X, Feng Z, Xu J. Comparison of biomarkers in rat renal ischemia-reperfusion injury. Int J Clin Exp Med. 2015 May 15;8(5):7577-84. eCollection 2015.
  44. Chevalier RL, Thornhill BA, Forbes MS, Kiley SC. Mechanisms of renal injury and progression of renal disease in congenital obstructive nephropathy. Pediatr Nephrol. 2010 Apr;25(4):687-97. doi: 10.1007/s00467-009-1316-5.
  45. Sugerman HJ, Bloomfield GL, Saggi BW. Multisystem organ failure secondary to increased intraabdominal pressure. Infection. 1999 Jan-Feb;27(1):61-6.
  46. Pearson EG, Rollins MD, Vogler SA, Mills MK, Lehman EL, Jacques E, et al. Decompressive laparotomy for abdominal compartment syndrome in children: before it is too late. J Pediatr Surg. 2010 Jun;45(6):1324-29. doi: 10.1016/j.jpedsurg.2010.02.107.
  47. Gel’fand BR, Protsenko DN, Chubchenko SV, Ignatenko OV. Sindrom intraabdominal’noi gipertenzii u khirurgicheskikh bol’nykh: sostoianie problemy v 2007g [Syndrome of intra-abdominal hypertension in surgical patients: the state of the problem in 2007 yr]. Infektsii v Khirurgii. 2007;5(3):20-29.
  48. Mitanchez D, Walter-Nicolet E, Humblot A, Rousseau V, Revillon Y, Hubert P. Neonatal care in patients with giant ompholocele: arduous management but favorable outcomes. J Pediatr Surg. 2010 Aug;45(8):1727-33. doi: 10.1016/j.jpedsurg.2010.04.011.
  49. Morozov DA, Filippov IV. Ocherki detskoi abdominal’noi khirurgii [Essays on Pediatric abdominal surgery]. Saratov, RF: Izd-vo SGMU; 2008. 140 p.
  50. Ozbey H. Use of sterile adhesive film and polypropylene mesh in the construction of a temporary silo in the treatment of omphalocele. Surg Today. 2005;35(8):700-2.
Address for correspondence:
119991, Russian Federation,
Moscow, Trubetskaya str., 8,
FSAEI HE I.M. Sechenov First Moscow State Medical University Ministry of Healthcare Russian Federation (Sechenov University),
Department of Pathophysiology,
tel. office: 8 (499) 622 96 47,
e-mail: morozova_ol@list.ru,
Olga L. Morozova
Information about the authors:
Morozov D.A., MD, Professor, Head of the Department of Pediatric Surgery, Urology and Andrology of FSAEI HE I.M. Sechenov First Moscow State Medical University MOH Russian Federation (Sechenov University).
Morozova O.L., MD, Professor of the Department of Pathophysiology of FSAEI HE I.M. Sechenov First Moscow State Medical University MOH Russian Federation (Sechenov University).
Klyuev S.A., Pediatric Surgeon, Post-Graduate Student of FSAE National Scientific Center of Children’s Health of the Ministry of Health of Russia.
Budnik I.A., PhD, Associate Professor of the Department of Pathophysiology of FSAEI HE I.M. Sechenov First Moscow State Medical University MOH Russian Federation (Sechenov University).
Maltseva L.D., PhD, Associate Professor of the Department of Pathophysiology of FSAEI HE I.M. Sechenov First Moscow State Medical University MOH Russian Federation (Sechenov University).
Morozov Ê.D., Student of FSAEI HE I.M. Sechenov First Moscow State Medical University MOH Russian Federation (Sechenov University).
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