Review Article

Abdominal Decompression in Children

Table 1

Reported clinical experience with abdominal decompression in children.

Study (Year)Study typePopulationnACS definition usedACS incidence (%)Mortality (%)Decompression type1° closure fascial (%)Days to closureComplications of decompression

Akhobadze et al. (2011) [12]RNeonates with IAP monitoring32IAP > 20 mmHg + 3 specified SOD34Grade I and II —17 Grade III —37.5 Grade IV —100PDNANANone

Steinau et al. (2011) [9]RNeonates and children with ACS28IAP > 12 mmHg + 1 specified SODNA21.4DL64.253 (10–63)ECF-21.4%, hernia needing repair-27.3%

Pearson et al. (2010) [8]RChildren with exploratory laparotomy264IAP > 12 mmHg + new SOD9.858DL100.08.6 (1–61)ECF, Renal failure

Ejike et al. (2007) [1]PCritically ill children with mechanical ventilation75IAP > 12 mmHg with new SOD4.7ACS –50 non-ACS –8.1PD, DLNRNRECF

Hershberger et al. (2007) [16]RBurn patients (adults and children); 7 children (ages 6 months to 8 years)25 of 5195IAP > 12 mmHg + specified SODNR88DL (n = 25), truncal escharaotomy in addition to DL (n = 13)16.0NRNR

Diaz et al. (2006) [17]PCritically ill children1052IAP > 10 mmHg + SOD0.940DL (n = 2) or PD (n = 5) NRNR NR

Latenser et al. (2002) [14]PBurn patients (adults and children) with >40% TBSA burns 9≥30 mm Hg + pulmonary or renal dysfunction0.7No IAH —50, IAH with PD—40, DL—100PD, DL with chest/abdominal escharotomyNRNRNR

Beck et al. (2001) [7]PPICU patients1762abdominal distention + IAP > 15 mmHg + at least 2 SOD0.6 (0.7% of trauma pts)60DL with Dacron Mesh or Bogota bagNRNRRecurrent ACS

Neville et al. (2000) [18]RPatch abdominoplasty for ACS23Elevated PIP, O2 req., or worsening renal or cardiac functionNR34.7DL with patch abdominoplasty47.8%6 (2–11)Intra-abdominal abscess and ECF

IAH, intra-abdominal hypertension; ACS, abdominal compartment syndrome; IAP, intra-abdominal pressure; n, number of patients, 1°, primary; R, retrospective; P, prospective; SOD, signs of organ dysfunction; PD, peritoneal dialysis; DL, decompressive laparotomy; PICU, Pediatric intensive care unit; ECF, enterocutaneous fistula; TBSA, total body surface area; NR, not reported, PIP, peak inspiratory pressure; req, requirement.
Adult studies that included pediatric patients.