Somatic regional oxygen saturation as an early marker of intra-abdominal hypertension in critically ill children: a pilot study

Abstract

Background/aim: Intraabdominal hypertension is a common clinical condition with high mortality and morbidity in pediatricintensive care units. The aim of this study was to test the feasibility of regional tissue oxygenation (rSO2) measurement using nearinfraredspectroscopy and to assess the correlation between rSO2 and perfusion markers of intraabdominal hypertension in high-riskpediatric patients.Materials and methods: In this prospective observational cohort study in a tertiary pediatric intensive care unit in ÇukurovaUniversity Faculty of Medicine, a total of 31 patients who were admitted between May 2017 and May 2018 with a risk of intraabdominalhypertension were included. Mesenteric and renal rSO2 measurements were taken and correlations with other tissue perfusion markersincluding mean arterial pressure, pH, lactate, intraabdominal pressure, abdominal perfusion pressure, mixed venous oxygen saturation,vasoactive inotropic score were assessed. Intraabdominal pressure was measured as ≥10 mmHg in 15 patients (48.3%) and these patientswere defined as the group with intraabdominal hypertension.Results: In the group with intraabdominal hypertension, mixed venous oxygen saturation was lower (P = 0.024), vasoactive inotropicscore was higher (P = 0.024) and the mean abdominal perfusion pressure value was lower (P = 0.014). In the ROC analysis, the mesentericrSO2 measurement was the best parameter to predict intraabdominal hypertension with area under the curve of 0.812 (P = 0.003) 95%CI [0.652–0.973].Conclusion: Monitoring of mesenteric rSO2 is feasible in patients at risk for intraabdominal hypertension. Moreover, both mesentericregional oxygen and perfusion markers may be used to identify pediatric patients at risk for intraabdominal hypertension.