Clinical Trial: Intra-Abdominal Hypertension in Neonatal Intensive Care Patients

Study Status: Completed
Recruit Status: Completed
Study Type: Observational

Official Title: Intra-Abdominal Hypertension in Neonatal Intensive Care Patients

Brief Summary: The observational study is designed to determine the feasibility of performing Intra-Abdominal Pressure (IAP) via bladder pressure measurements and of tracking IAP in neonates who require bladder catheterization. Correlation of IAP measurements with clinical status of the neonatal abdomen will help determine threshold values for Intra-Abdominal Hypertension (IAH) in the neonate.

Detailed Summary:

An increasingly common cause of Multiple Organ Dysfunction Syndrome (MODS) is mechanical injury/ischemia caused by elevated pressures within the abdominal cavity. This phenomenon has been termed intra-abdominal hypertension (IAH) with the final pathway of multiple organ dysfunction and failure termed abdominal compartment syndrome (ACS). In the neonate, IAH is known to accompany omphalocele, gastroschisis and diaphragmatic hernia repair. IAH has also been found to cause a need for neonatal extra corporeal membrane oxygenation (ECMO) and/or a subsequent failure of ECMO treatment.

While abdominal compartment syndrome is the final physiologic and clinically apparent expression of severe elevations of intra-abdominal pressure, earlier in the course of this process, significant organ dysfunction occurs at a sub-clinical level. If mild to moderately elevated abdominal pressure can be detected early, it may allow clinicians to intervene early and reverse the process, preventing progression to ACS and possibly reducing morbidity and mortality.

To date no study has investigated the correlation between bladder pressure (a surrogate measure of IAP) in neonates who may or may not have ACS. Thus, the ranges of normal and elevated IAP are not determined. There is suggestion from pediatric ICU patients that the threshold for IAH in children is less than that in adults. Likewise, the threshold for IAH in neonates may be expected to be even lower, but this remains to be determined.

In this study, IAP (via bladder pressure measurements) will be measured with a commercially available and FDA approved system which utilizes an electronic pressure transducer, tubing, and any bedside patient monitor with pressure measurement inputs. These types of monitors are standard in the NICU. The pressure t
Sponsor: University of Utah

Current Primary Outcome: Intra-abdominal Pressure(IAP) Measurements in NICU Patients. [ Time Frame: 3 years ]

Original Primary Outcome:

Current Secondary Outcome: Median Bladder Pressure for All Measurements [ Time Frame: 3 years ]

Original Secondary Outcome:

Information By: University of Utah

Dates:
Date Received: September 3, 2008
Date Started: January 2006
Date Completion:
Last Updated: January 22, 2010
Last Verified: January 2010