Intra abdominal pressure (IAP) is monitored in critically ill children because intra-abdominal hypertension (IAH) may be associated with renal dysfunction and adverse outcomes.

We retrospectively examined the incidence and clinical relevance of increased IAP, measured by the transurethral catheter method in 28 pediatric solid abdominal organ transplant recipients between 0-48 hours postoperatively from November 2011 to September 2013, by correlating IAP levels with mean blood pressure (MABP, mm Hg), abdominal perfusion pressure (APP), serum creatinine, urine output, graft and patient survival (at 1 year follow-up), hospital length of stay (LOS) and PICU LOS using Spearman's Coefficient. Isolated increases in IAP were classified as mild (10-14 cm H₂O), moderate (15-20 cm) and severe (>20 cm of water) with or without organ dysfunction. Mean IAP between 0-8 hours postoperatively was 7.6 ± 0.7 (Mean ± SEM) and did not change significantly over the first 48 hrs. IAP was >10 cms H₂O in 18/28 patients on one or more occasions. The peak IAP was 12.1 ± 0.9. Two cases of severe IAH were documented, who had lower MABP (67.2 ± 1.9), APP (53.4 ± 2.7), urine output (1.6 ± 0.36 ml/min) and greater Cr (0.5 ± 0.04) compared to patients with moderate and mild IAH. In summary, in our cohort, IAH did not affect graft or patient survival. Severe IAH, despite being infrequent, was associated with lower MABP, APP, urine output and worse renal function.

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