Semi-recumbent position and body mass percentiles: effects on intra-abdominal pressure measurements in critically ill children

Ejike, Janeth Chiaka; Kadry, Jose; Bahjri, Khaled; Mathur, Mudit
February 2010
Intensive Care Medicine;Feb2010, Vol. 36 Issue 2, p329
Academic Journal
Patient position and body mass index (BMI) affect intra-abdominal pressure (IAP) measured by the intra-vesical method in adults. We sought to determine effects of patient position and BMI on IAP in children because accurate measurement and interpretation of IAP are important for patient management. Seventy-seven mechanically ventilated children (<18 years) admitted to a PICU were prospectively studied. IAP was taken with the head of the bed at 0° and 30° every 6 h over a 24-h period. Statistical methods included descriptives, univariate statistics to identify potential confounding variables and multivariable analysis to assess the impact of position on IAP after adjusting for the significant covariates. Seventy-seven patients had 290-paired IAP measurements. Mean IAP at 30° was 10.6 ± 4.0 compared to 8.4 ± 4.0 at 0°, which was significantly higher ( p = 0.026) even after adjusting for age, gender and length. There was no correlation between IAP and actual BMI or BMI percentiles. Patient position should be considered when interpreting IAP. BMI did not influence IAP measurements in children.


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