Value of abdominal pressure measurement in neonatal abdominal surgical emergencies

ABSTRACT

To assess the predictive and prognostic value of abdominal pressure measurement in neonatal abdominal surgical emergencies. Case series. Zagazig University Hospitals [Egypt] and King Fahd Hospital, Hofuf [KSA]. Seventy nine neonatal abdominal surgical emergencies admitted and managed over a four-year period [Jan 2005 to Jan 2009] Measurement of abdominal pressure through management period. Abdominal pressure was classified into pressure at presentation [T1], preoperative [T2], and postoperative pressure [T3]. The levels of pressure were classified into [pA] below 12 mmHg, [pB] 12-20 mmHg, and [pC] more than 20 mmHg. Seventy-nine neonates were included. There was significant high abdominal pressure in jejunoileal atresia, necrotizing enterocolitis [NEC], and duodenal obstruction. In pyloric stenosis, there was no significant abdominal hypertension all over the management period. Temporary elevations occurred preoperatively [T1] in meconium ileus, cecal perforation, and jejunal stenosis. Significant association was found between [T1] and mortality, postoperative blood transfusion, need for mechanical ventilation, and sepsis. No correlation was found with blood need or sepsis. Postoperative complications had significant association with elevated postoperative abdominal pressure [T3]. Intra-abdominal pressure [IAP] can be of importance in monitoring changes which accompany neonatal surgical emergencies. It can be of predictive and prognostic value in neonatal surgical emergencies. However, more controlled studies are needed to confirm this conclusion: