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Intra-Abdominal Hypertension and Compartment Syndrome after Pediatric Liver Transplantation: Incidence, Risk Factors and Outcome

In pediatric liver transplantation (pLT), the risk for the manifestation and relevance of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) is high. This observational study aimed to evaluate the incidence, relevance and risk factors for IAH and ACS by monitoring the intra-...

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Autores principales: Junge, Norman, Artmann, Annika, Richter, Nicolas, Vondran, Florian W. R., Böthig, Dietmar, Sasse, Michael, Köditz, Harald, Baumann, Ulrich, Beerbaum, Philipp, Kaussen, Torsten
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9777324/
https://www.ncbi.nlm.nih.gov/pubmed/36553436
http://dx.doi.org/10.3390/children9121993
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author Junge, Norman
Artmann, Annika
Richter, Nicolas
Vondran, Florian W. R.
Böthig, Dietmar
Sasse, Michael
Köditz, Harald
Baumann, Ulrich
Beerbaum, Philipp
Kaussen, Torsten
author_facet Junge, Norman
Artmann, Annika
Richter, Nicolas
Vondran, Florian W. R.
Böthig, Dietmar
Sasse, Michael
Köditz, Harald
Baumann, Ulrich
Beerbaum, Philipp
Kaussen, Torsten
author_sort Junge, Norman
collection PubMed
description In pediatric liver transplantation (pLT), the risk for the manifestation and relevance of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) is high. This observational study aimed to evaluate the incidence, relevance and risk factors for IAH and ACS by monitoring the intra-abdominal pressure (IAP), macro- and microcirculation (near-infrared spectroscopy (NIRS)), clinical and laboratory status and outcomes of 27 patients (16 female) after pLT (median age at pLT 35 months). Of the patients, 85% developed an elevated IAP, most of them mild. However, 17% achieved IAH° 3, 13% achieved IAH° 4 and 63% developed ACS. A multiple linear regression analysis identified aortal hepatic artery anastomosis and cold ischemia time (CIT) as risk factors for increased IAP and longer CIT and staged abdominal wall closure for ACS. ACS patients had significantly longer mechanical ventilation (p = 0.004) and LOS-PICU (p = 0.003). No significant correlation between NIRS or biliary complications and IAH or ACS could be shown. IAH and ACS after pLT were frequent. NIRS or grade of IAH alone should not be used for monitoring. A longer CIT is an important risk factor for higher IAP and ACS. Therefore, approaches such as the ex vivo machine perfusion of donor organs, reducing CIT effects on them, have great potential. Our study provides important basics for studying such approaches.
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spelling pubmed-97773242022-12-23 Intra-Abdominal Hypertension and Compartment Syndrome after Pediatric Liver Transplantation: Incidence, Risk Factors and Outcome Junge, Norman Artmann, Annika Richter, Nicolas Vondran, Florian W. R. Böthig, Dietmar Sasse, Michael Köditz, Harald Baumann, Ulrich Beerbaum, Philipp Kaussen, Torsten Children (Basel) Article In pediatric liver transplantation (pLT), the risk for the manifestation and relevance of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) is high. This observational study aimed to evaluate the incidence, relevance and risk factors for IAH and ACS by monitoring the intra-abdominal pressure (IAP), macro- and microcirculation (near-infrared spectroscopy (NIRS)), clinical and laboratory status and outcomes of 27 patients (16 female) after pLT (median age at pLT 35 months). Of the patients, 85% developed an elevated IAP, most of them mild. However, 17% achieved IAH° 3, 13% achieved IAH° 4 and 63% developed ACS. A multiple linear regression analysis identified aortal hepatic artery anastomosis and cold ischemia time (CIT) as risk factors for increased IAP and longer CIT and staged abdominal wall closure for ACS. ACS patients had significantly longer mechanical ventilation (p = 0.004) and LOS-PICU (p = 0.003). No significant correlation between NIRS or biliary complications and IAH or ACS could be shown. IAH and ACS after pLT were frequent. NIRS or grade of IAH alone should not be used for monitoring. A longer CIT is an important risk factor for higher IAP and ACS. Therefore, approaches such as the ex vivo machine perfusion of donor organs, reducing CIT effects on them, have great potential. Our study provides important basics for studying such approaches. MDPI 2022-12-18 /pmc/articles/PMC9777324/ /pubmed/36553436 http://dx.doi.org/10.3390/children9121993 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Junge, Norman
Artmann, Annika
Richter, Nicolas
Vondran, Florian W. R.
Böthig, Dietmar
Sasse, Michael
Köditz, Harald
Baumann, Ulrich
Beerbaum, Philipp
Kaussen, Torsten
Intra-Abdominal Hypertension and Compartment Syndrome after Pediatric Liver Transplantation: Incidence, Risk Factors and Outcome
title Intra-Abdominal Hypertension and Compartment Syndrome after Pediatric Liver Transplantation: Incidence, Risk Factors and Outcome
title_full Intra-Abdominal Hypertension and Compartment Syndrome after Pediatric Liver Transplantation: Incidence, Risk Factors and Outcome
title_fullStr Intra-Abdominal Hypertension and Compartment Syndrome after Pediatric Liver Transplantation: Incidence, Risk Factors and Outcome
title_full_unstemmed Intra-Abdominal Hypertension and Compartment Syndrome after Pediatric Liver Transplantation: Incidence, Risk Factors and Outcome
title_short Intra-Abdominal Hypertension and Compartment Syndrome after Pediatric Liver Transplantation: Incidence, Risk Factors and Outcome
title_sort intra-abdominal hypertension and compartment syndrome after pediatric liver transplantation: incidence, risk factors and outcome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9777324/
https://www.ncbi.nlm.nih.gov/pubmed/36553436
http://dx.doi.org/10.3390/children9121993
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