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Open Abdomen pp 141-152 | Cite as

The Open Abdomen in Infants and Children

  • Davide Corbella
  • Oliviero Fochi
  • Mirco Nacoti
Chapter
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)

Abstract

Despite the long-standing experience in staged closure and open abdomen treatment, there is a wide spread reluctance to implement these treatments in the pediatric patients. Whereas the open abdomen has a sound and recognized role in the adult literature, the pediatric one lags behind showing that:
  • Intra-abdominal pressure is not measured on a routine basis.

  • Cut-off of intra-abdominal hypertension is often not standardized in the clinical practice.

  • The definition of abdominal compartment syndrome appears to be not so well understood in the pediatric intensivist community.

  • Open abdomen treatment is often reserved for “hopeless” cases with poor results.Aim of this chapter is to give an over view of the current state-of-art of open abdomen and acute compartment syndrome in the pediatric population. We will highlight definition of abdominal compartment syndrome, the way to measure the intra-abdominal pressure, the evidence of the implementation of open abdomen treatment with its outcome and the cases peculiar to the pediatric population (e.g. abdominal wall defects or mismatch between adult graft and pediatric abdominal domain).

References

  1. 1.
    Malbrain MLNG, Cheatham ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, et al. Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. I. Definitions. Intensive Care Med. 2006;32:1722–32.CrossRefPubMedGoogle Scholar
  2. 2.
    Cheatham ML, Malbrain MLNG, Kirkpatrick A, Sugrue M, Parr M, De Waele J, et al. Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. II. Recommendations. Intensive Care Med. 2007;33:951–62.CrossRefPubMedGoogle Scholar
  3. 3.
    Kirkpatrick AW, Roberts DJ, De Waele J, Jaeschke R, Malbrain MLNG, De Keulenaer B, et al. Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med. 2013;39:1190–206.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Gross RE. A new method for surgical treatment of large omphaloceles. Surgery. 1948;24:277–92.PubMedGoogle Scholar
  5. 5.
    Kimball EJ, Rollins MD, Mone MC, Hansen HJ, Baraghoshi GK, Johnston C, et al. Survey of intensive care physicians on the recognition and management of intra-abdominal hypertension and abdominal compartment syndrome. Crit Care Med. 2006;34:2340–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Kaussen T, Steinau G, Srinivasan PK, Otto J, Sasse M, Staudt F, et al. Recognition and management of abdominal compartment syndrome among German pediatric intensivists: results of a national survey. Ann Intensive Care. 2012;2(Suppl 1):S8.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Balogh ZJ, Butcher NE. Compartment syndromes from head to toe. Crit Care Med. 2010;38:S445–51.CrossRefPubMedGoogle Scholar
  8. 8.
    Malbrain MLNG, Roberts DJ, Sugrue M, De Keulenaer BL, Ivatury R, Pelosi P, et al. The polycompartment syndrome: a concise state-of-the-art review. Anaesthesiol Intensive Ther. 2014;46:433–50.CrossRefPubMedGoogle Scholar
  9. 9.
    Malbrain MLNG, Wilmer A. The polycompartment syndrome: towards an understanding of the interactions between different compartments! Intensive Care Med. 2007;33:1869–72.CrossRefPubMedGoogle Scholar
  10. 10.
    Scalea TM, Bochicchio GV, Habashi N, McCunn M, Shih D, McQuillan K, et al. Increased intra-abdominal, intrathoracic, and intracranial pressure after severe brain injury: multiple compartment syndrome. J Trauma. 2007;62:647–56. discussion 656.CrossRefPubMedGoogle Scholar
  11. 11.
    Cheatham ML. Abdominal compartment syndrome: pathophysiology and definitions. Scand J Trauma Resusc Emerg Med. 2009;17:10.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Beck R, Halberthal M, Zonis Z, Shoshani G, Hayari L, Bar-Joseph G. Abdominal compartment syndrome in children. Pediatr Crit Care Med. 2001;2:51–6.CrossRefPubMedGoogle Scholar
  13. 13.
    Sugrue M, Bauman A, Jones F, Bishop G, Flabouris A, Parr M, et al. Clinical examination is an inaccurate predictor of intraabdominal pressure. World J Surg. 2002;26:1428–31.CrossRefPubMedGoogle Scholar
  14. 14.
    Davis PJ, Koottayi S, Taylor A, Butt WW. Comparison of indirect methods of measuring intra-abdominal pressure in children. Intensive Care Med. 2005;31:471–5.CrossRefPubMedGoogle Scholar
  15. 15.
    De Waele J, Pletinckx P, Blot S, Hoste E. Saline volume in transvesical intra-abdominal pressure measurement: enough is enough. Intensive Care Med. 2006;32:455–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Ejike JC, Bahjri K, Mathur M. What is the normal intra-abdominal pressure in critically ill children and how should we measure it? Crit Care Med. 2008;36:2157–62.CrossRefPubMedGoogle Scholar
  17. 17.
    Pearson EG, Rollins MD, Vogler SA, Mills MK, Lehman EL, Jacques E, et al. Decompressive laparotomy for abdominal compartment syndrome in children: before it is too late. J Pediatr Surg. 2010;45:1324–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Rollins MD, Deamorim-Filho J, Scaife ER, Hubbard A, Barnhart DC. Decompressive laparotomy for abdominal compartment syndrome in children on ECMO: effect on support and survival. J Pediatr Surg. 2013;48:1509–13.CrossRefPubMedGoogle Scholar
  19. 19.
    Horoz OO, Yildizdas D, Asilioglu N, Kendirli T, Erkek N, Anil AB, et al. The prevalance of and factors associated with intra-abdominal hypertension on admission day in critically ill pediatric patients: a multicenter study. J Crit Care. 2015;30:584–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Christison-Lagay ER, Kelleher CM, Langer JC. Neonatal abdominal wall defects. Semin Fetal Neonatal Med. 2011;16:164–72.CrossRefPubMedGoogle Scholar
  21. 21.
    Rizzo A, Davis PC, Hamm CR, Powell RW. Intraoperative vesical pressure measurements as a guide in the closure of abdominal wall defects. Am Surg. 1996;62:192–6.PubMedGoogle Scholar
  22. 22.
    Santos Schmidt AF, Goncalves A, Bustorff-Silva JM, Oliveira-Filho AG, Miranda ML, Oliveira ER, et al. Monitoring intravesical pressure during gastroschisis closure. Does it help to decide between delayed primary or staged closure? J Mater Fetal Neonatal Med. 2012;25:1438–41.CrossRefGoogle Scholar
  23. 23.
    Maxwell D, Baird R, Puligandla P. Abdominal wall closure in neonates after congenital diaphragmatic hernia repair. J Pediatr Surg. 2013;48:930–4.CrossRefPubMedGoogle Scholar
  24. 24.
    Dotta A, Rechichi J, Campi F, Braguglia A, Palamides S, Capolupo I, et al. Effects of surgical repair of congenital diaphragmatic hernia on cerebral hemodynamics evaluated by near-infrared spectroscopy. J Pediatr Surg. 2005;40:1748–52.CrossRefPubMedGoogle Scholar
  25. 25.
    Fontana I, Bertocchi M, Centanaro M, Varotti G, Santori G, Mondello R, et al. Abdominal compartment syndrome: an underrated complication in pediatric kidney transplantation. Transplant Proc. 2014;46:2251–3.CrossRefPubMedGoogle Scholar
  26. 26.
    Gupte GL, Haghighi KS, Sharif K, Mayer DA, Beath SV, Kelly DA, et al. Surgical complications after intestinal transplantation in infants and children--UK experience. J Pediatr Surg. 2010;45:1473–8.CrossRefPubMedGoogle Scholar
  27. 27.
    Sheth J, Sharif K, Lloyd C, Gupte G, Kelly D, de Ville de Goyet J, et al. Staged abdominal closure after small bowel or multivisceral transplantation. Pediatr Transplant. 2012;16:36–40.CrossRefPubMedGoogle Scholar
  28. 28.
    Ong TH, Strong R, Zahari Z, Yamanaka J, Lynch S, Balderson G, et al. The management of difficult abdominal closure after pediatric liver transplantation. J Pediatr Surg. 1996;31:295–6.CrossRefPubMedGoogle Scholar
  29. 29.
    Ziaziaris WA, Darani A, Holland AJA, Alexander A, Karpelowsky J, Shun A, et al. Delayed primary closure and the incidence of surgical complications in pediatric liver transplant recipients. J Pediatr Surg. 2015;50:2137–40.CrossRefPubMedGoogle Scholar
  30. 30.
    Sukhotnik I, Riskin A, Bader D, Lieber M, Shamian B, Coran AG, et al. Possible importance of increased intra-abdominal pressure for the development of necrotizing enterocolitis. Eur J Pediatr Surg. 2009;19:307–10.CrossRefPubMedGoogle Scholar
  31. 31.
    Zani A, Eaton S, Puri P, Rintala R, Lukac M, Bagolan P, et al. International survey on the management of necrotizing enterocolitis. Eur J Pediatr Surg. 2015;25:27–33.CrossRefPubMedGoogle Scholar
  32. 32.
    Tanriverdi S, Koroglu O, Uygur O, Celik A, Dulger F, Yalaz M, et al. Serial intravesical pressure measurements can predict the presence and the severity of necrotizing enterocolitis. Eur J Pediatr Surg. 2013;23:243–8.CrossRefPubMedGoogle Scholar
  33. 33.
    Floh AA, Slicker J, Schwartz SM. Nutrition and mesenteric issues in pediatric cardiac critical care. Pediatr Crit Care Med. 2016;17:S243–9.CrossRefPubMedGoogle Scholar
  34. 34.
    Pathan N, Burmester M, Adamovic T, Berk M, Ng KW, Betts H, et al. Intestinal injury and endotoxemia in children undergoing surgery for congenital heart disease. Am J Respir Crit Care Med. 2011;184:1261–9.CrossRefPubMedGoogle Scholar
  35. 35.
    Prodhan P, Imamura M, Garcia X, Byrnes JW, Bhutta AT, Dyamenahalli U. Abdominal compartment syndrome in newborns and children supported on extracorporeal membrane oxygenation. ASAIO J. 2012;58:143–7.PubMedGoogle Scholar
  36. 36.
    Divarci E, Karapinar B, Yalaz M, Ergun O, Celik A. Incidence and prognosis of intraabdominal hypertension and abdominal compartment syndrome in children. J Pediatr Surg. 2016;51:503–7.CrossRefPubMedGoogle Scholar
  37. 37.
    Ejike JC, Humbert S, Bahjri K, Mathur M. Outcomes of children with abdominal compartment syndrome. Acta Clin Belg. 2007;62(Suppl 1):141–8.CrossRefPubMedGoogle Scholar
  38. 38.
    Steinau G, Kaussen T, Bolten B, Schachtrupp A, Neumann UP, Conze J, et al. Abdominal compartment syndrome in childhood: diagnostics, therapy and survival rate. Pediatr Surg Int. 2011;27:399–405.CrossRefPubMedGoogle Scholar
  39. 39.
    Thabet FC, Bougmiza IM, Chehab MS, Bafaqih HA, AlMohaimeed SA, Malbrain MLNG. Incidence, risk factors, and prognosis of intra-abdominal hypertension in critically ill children: a prospective epidemiological study. J Intensive Care Med. 2016;31:403–8.CrossRefPubMedGoogle Scholar
  40. 40.
    Neville HL, Lally KP, Cox CS. Emergent abdominal decompression with patch abdominoplasty in the pediatric patient. J Pediatr Surg. 2000;35:705–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Davide Corbella
    • 1
    • 2
  • Oliviero Fochi
    • 1
  • Mirco Nacoti
    • 1
  1. 1.Department of Anesthesia and Intensive Care MedicineASST Papa Giovanni XXIIBergamoItaly
  2. 2.Department of Anesthesia & Pain ManagementToronto General Hospital, University Health NetworkTorontoCanada

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