İntra-abdominal measurement and evaluation of patients in neonatal unit

Introduction and aim: IAH and AKS, especially during last decade, have taken place among the reasons of significant morbidity and mortality in serious surgical and medical patients. The significant prognostic value of increased IAB caused this physiological parameter measurement to become nearly routine vital parameters in these patients. With our research it is aimed to identify the normally acceptable values of this physiological parameter in the patients observed in neonatal intensive care unit, to determine the pressure value predicted for IAH and AKS and follow the clinical and laboratory reflections of the pressure value.Materials and Method: In this research, IAB of 76 patients who have stayed more than 24 hours in neonatal intensive care unit (NICU) in 2011 and who have orogastric catheter have measured. The patients who were in supine position with totally empty stomaches and were provided drenage with no:8 feeding were given isotonic in the amount of 1 ml/kg. The isotonic level of the vertically holded feeding, the distance between midaxiller line was measured in cmH2O. Measurement values were turned into mmHg and transcribed. This measurement was applied 4 times in 24 hours with 6-hours intervals. The patients? clinical and laboratory follow-ups, needed treatments and survivals were noted.Findings: IAB value of 29 patients without risk was between 0-3.99 mmHg. 5 of 47 patients under risk were 10 mmHg and over and this value was evaluated as IAH. Four of 5 patients were being followed in mechanical ventilator. In 3 of the patients AKS developed and these patients showed mortal course. The values of BUN, creatinin, AST, ALT, pCO2 ve HCO3 of the patients found significant. Also, patients with IAH needed more repiration support and their rate of sepsis was found increased. A significant relation was identified between mortality and IAH.Results: In measurement of the critical patients followed in neonatal intensive care unit (NICU), IAB must be measured by orogastric catheter which is a very simple measurement method. More researches must be carried out to determine an average APB to show proper tissue perfussion for pediatric age group. It must be foreseen that the mortality and morbidity of IAH patients are worse and in the future the measurement of IAB must be routine in critical patients.Keywords: IAP (Intra Abdominal Pressure), IAH (Intra Abdominal Hypertension), ACP (Abdominal Compartment Syndrome) NICU (Neonatal Intensive Care Unit), critically ill patients