Abstract
Background/Purpose: Abdominal compartment syndrome (ACS) is the cardiac, pulmonary, and renal dysfunction that occurs as a result of elevated intraabdominal pressure. The authors present their experience with patch abdominoplasty (PA) in pediatric patients as a means to treat and prevent ACS. Methods: The charts of patients who underwent PA were reviewed retrospectively. ACS was defined as the increased oxygen requirements and elevation of peak inspiratory pressures (PIP) associated with abdominal distension and worsening renal and or cardiac function. Results: A total of 23 patients (13 boys) were treated (average age, 23 months). Diagnoses included necrotizing enterocolitis (NEC, n = 13), trauma (n = 3), Hirschsprung's enterocolitis (n = 2), perforated bowel (n = 4), and bilateral Wilms' tumor with bowel obstruction (n = 1). Oxygen requirements decreased after patch abdominoplasty (mean preoperative FlO 2, 0.87 ± 24, mean postoperative, 0.67 ± 24 [P = .01]). The PIP decreased significantly in the 13 patients who survived (mean preoperative PIP, 33 ± 8, mean postoperative PIP, 27 ± 7 [P= .01]). These PIPs failed to respond in the 8 nonsurvivors (mean preoperative PIP, 35 ± 10, mean postoperative PIP, 33 ± 14 [P value not significant]). Six of the 8 nonsurvivors had NEC. Complications of intraabdominal abscess and enterocutaneous fistula were seen in 5 patients, all of who had NEC. Conclusions: Patch abdominoplasty effectively decreases airway pressures and oxygen requirements associated with ACS. Complications with PA occur primarily in patients with NEC. Failure to respond with a decrease in PIP and FIO 2 requirements is an ominous sign. Copyright (C) 2000 by W.B. Saunders Company.
| Original language | English |
|---|---|
| Pages (from-to) | 705-708 |
| Number of pages | 4 |
| Journal | Journal of Pediatric Surgery |
| Volume | 35 |
| Issue number | 5 |
| State | Published - May 1 2000 |
| Externally published | Yes |
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Keywords
- Abdominoplasty
- Intraabdominal hypertension
- Mesh
ASJC Scopus subject areas
- Surgery
Cite this
Emergent abdominal decompression with patch abdominoplasty in the pediatric patient. / Neville, Holly; Lally, Kevin P.; Cox, Charles S.
In: Journal of Pediatric Surgery, Vol. 35, No. 5, 01.05.2000, p. 705-708.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Emergent abdominal decompression with patch abdominoplasty in the pediatric patient
AU - Neville, Holly
AU - Lally, Kevin P.
AU - Cox, Charles S.
PY - 2000/5/1
Y1 - 2000/5/1
N2 - Background/Purpose: Abdominal compartment syndrome (ACS) is the cardiac, pulmonary, and renal dysfunction that occurs as a result of elevated intraabdominal pressure. The authors present their experience with patch abdominoplasty (PA) in pediatric patients as a means to treat and prevent ACS. Methods: The charts of patients who underwent PA were reviewed retrospectively. ACS was defined as the increased oxygen requirements and elevation of peak inspiratory pressures (PIP) associated with abdominal distension and worsening renal and or cardiac function. Results: A total of 23 patients (13 boys) were treated (average age, 23 months). Diagnoses included necrotizing enterocolitis (NEC, n = 13), trauma (n = 3), Hirschsprung's enterocolitis (n = 2), perforated bowel (n = 4), and bilateral Wilms' tumor with bowel obstruction (n = 1). Oxygen requirements decreased after patch abdominoplasty (mean preoperative FlO 2, 0.87 ± 24, mean postoperative, 0.67 ± 24 [P = .01]). The PIP decreased significantly in the 13 patients who survived (mean preoperative PIP, 33 ± 8, mean postoperative PIP, 27 ± 7 [P= .01]). These PIPs failed to respond in the 8 nonsurvivors (mean preoperative PIP, 35 ± 10, mean postoperative PIP, 33 ± 14 [P value not significant]). Six of the 8 nonsurvivors had NEC. Complications of intraabdominal abscess and enterocutaneous fistula were seen in 5 patients, all of who had NEC. Conclusions: Patch abdominoplasty effectively decreases airway pressures and oxygen requirements associated with ACS. Complications with PA occur primarily in patients with NEC. Failure to respond with a decrease in PIP and FIO 2 requirements is an ominous sign. Copyright (C) 2000 by W.B. Saunders Company.
AB - Background/Purpose: Abdominal compartment syndrome (ACS) is the cardiac, pulmonary, and renal dysfunction that occurs as a result of elevated intraabdominal pressure. The authors present their experience with patch abdominoplasty (PA) in pediatric patients as a means to treat and prevent ACS. Methods: The charts of patients who underwent PA were reviewed retrospectively. ACS was defined as the increased oxygen requirements and elevation of peak inspiratory pressures (PIP) associated with abdominal distension and worsening renal and or cardiac function. Results: A total of 23 patients (13 boys) were treated (average age, 23 months). Diagnoses included necrotizing enterocolitis (NEC, n = 13), trauma (n = 3), Hirschsprung's enterocolitis (n = 2), perforated bowel (n = 4), and bilateral Wilms' tumor with bowel obstruction (n = 1). Oxygen requirements decreased after patch abdominoplasty (mean preoperative FlO 2, 0.87 ± 24, mean postoperative, 0.67 ± 24 [P = .01]). The PIP decreased significantly in the 13 patients who survived (mean preoperative PIP, 33 ± 8, mean postoperative PIP, 27 ± 7 [P= .01]). These PIPs failed to respond in the 8 nonsurvivors (mean preoperative PIP, 35 ± 10, mean postoperative PIP, 33 ± 14 [P value not significant]). Six of the 8 nonsurvivors had NEC. Complications of intraabdominal abscess and enterocutaneous fistula were seen in 5 patients, all of who had NEC. Conclusions: Patch abdominoplasty effectively decreases airway pressures and oxygen requirements associated with ACS. Complications with PA occur primarily in patients with NEC. Failure to respond with a decrease in PIP and FIO 2 requirements is an ominous sign. Copyright (C) 2000 by W.B. Saunders Company.
KW - Abdominoplasty
KW - Intraabdominal hypertension
KW - Mesh
UR - http://www.scopus.com/inward/record.url?scp=0034098128&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034098128&partnerID=8YFLogxK
M3 - Article
C2 - 10813330
AN - SCOPUS:0034098128
VL - 35
SP - 705
EP - 708
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 5
ER -