Intra-Abdominal Hypertension
Conditions
Interventions
This is an observational study involving 24 mechanically ventilated children admitted to the intensive care unit. Participants will not be allocated in groups.
Included patients will undergo abdominal
grade II (16 and 20 mmHg)
grade III (21 and 25 mmHg)
and grade IV (greater than 25 mmHg).
If the value found is within grade II or higher, progressive decompression of the right hypochondrium will be performed, and a new measurement of the dependent var
Procedure/surgery
E01.370.350.130.750.220.225
Sponsors
Hospital das Clínicas da Universidade Estadual de Campinas
Hospital das Clínicas da Universidade Estadual de Campinas
Eligibility
Age
28 Days to 14 Years
Inclusion criteria
Inclusion criteria: Age between 28 days and 14 years old; need for central venous catheterization due to the clinical condition that justified the hospitalization; presence of bladder catheter that allows IAP measurement; patients with clinical criteria for IAP monitoring due to the risk of abdominal hypertension caused by the disease that justified their hospitalization; patients under invasive mechanical ventilation with tidal volume between 8 and 10 ml / kg of ideal weight and mean airway pressure between 8 and 12 cmH20; hemodinamically stable patients defined as age-appropriate heart rate and blood pressure (between the 10th and 90th percentiles); patients with respiratory stability defined as age-appropriate respiratory rate and arterial O2 saturation greater than 94% as measured by pulse oximetry; availability of the researcher responsible for performing the ultrasound exam.
Exclusion criteria
Exclusion criteria: Previous venous thrombosis in internal jugular veins; presence of collateral venous circulation in the cervical region in patients with a history of previous internal jugular vein catheterizations; Initial intra-abdominal pressure greater than 12 mmHg; peritoneal dialysis; skin lesions in the right upper quadrant of the abdomen; skin lesions in the cervical region; continuous dobutamine infusion at doses greater than 5 mcg / kg / min, adrenaline at doses greater than 0.1 mcg / kg / min, noradrenaline at doses greater than 0.1 mcg / kg / min, or milrinone at doses greater than 0.25 mcg / kg / min; intense psychomotor agitation impairing ultrasound examination.
Design outcomes
Secondary
| Measure | Time frame |
|---|---|
| Cardiac index, measured by transthoracic echocardiography, during the hepatic compression maneuver. ;Intra-abdominal pressure, measured through intravesical catheter using the Y-set technique and water column, during the hepatic compression maneuver. | — |
Primary
| Measure | Time frame |
|---|---|
| The primary outcome was defined as an increased of 25% in the sectional area of internal jugular veins. This outcome will be evaluated through ultrasonography during the hepatic compression maneuver. | — |
Countries
Brazil
Contacts
Public ContactTiago de Souza
Hospital das Clínicas da Universidade Estadual de Campinas
Outcome results
None listed