title: Predictive factors of abdominal compartment syndrome in neonatal age.
abstract: In the pediatric population, abdominal compartment syndrome (ACS) is a known complication of abdominal wall defect repair. However, there are only few reports on ACS in newborns and only a proposal of critical intra-abdominal pressure value (IAP) in term newborns, absent in preterm newborns. Although the prevalent clinical sign is tense abdominal distension, it may be difficult to distinguish ACS from pathologies that will not require decompression. The purpose of this study was to identify predictors for ACS and therefore morbidity or mortality indicators. We reviewed newborns presenting with tense abdominal distension and end organ failure. Anamnestic, clinical, laboratory, and instrumental investigations were analyzed to extrapolate predictors. Outcomes were compared with a control group. The incidence of ACS in our neonatal intensive care unit was 5% in the overall population of babies, 16% in tracheal-ventilated newborns, and 57% in infants with abdominal wall defects. We found that, with onset of acidosis or high gastric residuals, the lactate values will be predictive for mortality. We can also suggest paying particular attention to high lactate values just at the onset of distension, in infants with more advanced gestational age, with previously surgical repair, to determine early surgical intervention independently of a specific IAP measurement.
authors: Dipartimento Universitario Materno Infantile, Unità Operativa Complessa di Neonatologia e Terapia Intensiva Neonatale, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Palermo, Italy.
authors: Ingrid Anne Mandy
authors: IA
authors: Schierz
authors: Dipartimento Universitario Materno Infantile, Unità Operativa Complessa di Neonatologia e Terapia Intensiva Neonatale, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Palermo, Italy.
authors: Mario
authors: M
authors: Giuffrè
authors: Dipartimento Universitario Materno Infantile, Unità Operativa Complessa di Neonatologia e Terapia Intensiva Neonatale, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Palermo, Italy.
authors: Ettore
authors: E
authors: Piro
authors: Dipartimento Universitario Materno Infantile, Unità Operativa Complessa di Neonatologia e Terapia Intensiva Neonatale, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Palermo, Italy.
authors: Rita
authors: R
authors: Ortolano
authors: Unità Operativa di Chirurgia Pediatrica, Dipartimento Universitario Materno Infantile, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Palermo, Italy.
authors: Fortunato
authors: F
authors: Siracusa
authors: Dipartimento Universitario Materno Infantile, Unità Operativa Complessa di Neonatologia e Terapia Intensiva Neonatale, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Palermo, Italy.
authors: Giuseppa
authors: G
authors: Pinello
authors: Dipartimento Universitario Materno Infantile, Unità Operativa Complessa di Neonatologia e Terapia Intensiva Neonatale, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Palermo, Italy.
authors: Simona
authors: S
authors: La Placa
authors: Dipartimento Universitario Materno Infantile, Unità Operativa Complessa di Neonatologia e Terapia Intensiva Neonatale, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Università degli Studi di Palermo, Palermo, Italy.
authors: Giovanni
authors: G
authors: Corsello
mesh_terms: D034861:Abdominal Wall / Q000002:abnormalities / Q000601:surgery*; D001034:Apgar Score; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D059325:Intra-Abdominal Hypertension / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D007442:Intubation, Intratracheal; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D012121:Respiration, Artificial; D012189:Retrospective Studies
chemical_list: D019344:Lactic Acid