Author Of 1 Presentation
INTRAABDOMINAL PRESSURE IN PEDIATRIC KIDNEY TRANSPLANTATION
Abstract
Background
After kidney transplantation (NTX) in children high intraabdominal pressure may impair graft perfusion and graft function.
Objectives
We analysed whether longitudinal intraabdominal pressure (IAP) measurement is feasible and safe postoperatively in these patients and if IAP affects graft function after kidney transplantation in the pediatric intensive care setting.
Methods
We longitudinally measured IAP values using an Unometer™Abdo-Pressure™device connected to a Foley urinary catheter in eight children who underwent kidney transplantation (mean (SD) age: 9.6 (6.1) years) and in 18 controls (mean (SD) age: 5.9 (6.0) years) for 96 hours postoperatively. Vital signs and clinical parameters were documented in both groups. Graft function was evaluated using serum creatinine and urea nitrogen. Correlations were calculated using the Spearman rank correlation method.
Results
We analysed 29 measurements of IAP in children after NTX and 71 IAP measurements in control patients. Mean (SD) IAP were similar in both groups (NTX: 7.4 (4.2) mmHg, Controls: 7.4 (3.4) mmHg; p=0.74). IAP values exceeded the threshold of 10 mmHg indicating intraabdominal hypertension in 20% vs. 22% of the cases in NTX patients vs. in controls. The IAP was not correlated with diuresis, fluid balance, abdominal perfusion pressure (=mean arterial pressure – IAP) or graft function. IAP measurements did not cause complications in particular no urinary tract infection occurred in both groups.
Conclusion
Perioperative intraabdominal pressure monitoring is safe and feasible after pediatric kidney transplantation. IAP values were similar in NTX patients and controls. No correlation between intraabdominal pressure, graft function, diuresis or fluid balance were detected.