Study on volume of infusion before measure intra-abdominal pressure via the bladder in children / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the volume of infusion before measure intra-abdominal pressure (IAP) via the bladder in children and provide a more accurate value of the IAP in clinical measurements.Methods Direct measure IAP during laparoscopy compared with indirect measure IAP via the bladder after infusion of 1 mL/kg or a total of 25 mL 9 g/L saline to evaluate the optimum bladder infusion volume in children.Results A total of 21 children scheduling laparoscopy recruited in the study.The value of normal IAP measured via the bladder in children was 0.40-6.69 mm Hg(1 mm Hg =0.133 kPa).The indirect IAP measured via the bladder was positively associated with the direct IAP.The regression equations were Y=2.869 +0.706X(r =0.835,R2 =0.698) for the infusion of 1 mL/kg 9 g/L saline and Y =3.734 + 0.735X(r =0.796,R2 =0.633) for the infusion of 25 mL 9 g/L saline.There was no significant difference in slopes between the 2 regression equations(P =0.275).Sixteen out of 21 (76.2％) children's indirect IAP measured via the bladder were higher than their direct IAP,while 5 of 21 cases(23.8％) were lower.The area under receiver-operator characteristic (ROC) curve for direct IAP and accelerated heart rate was 0.863 and that area for direct IAP and quicken respiration was 0.845.Conclusions The measurement of indirect IAP via the bladder is able to predict the practical lAP in children population.There is no difference in IAP measured via the bladder between the infusion of 1 mL/kg and a total of 25 mL 9 g/L saline.The IAP measured via the bladder after infusion of 1 mL/kg 9 g/L saline is more related to the direct IAP than the volume of 25 mL 9 g/L saline.The value of intraabdominal hypertension in children can be defined as direct IAP ≥9 mm Hg.