Intravesical monitoring of intra-abdominal pressure after renal transplantation in children: A safety and feasibility study

Pediatr Transplant. 2020 Nov;24(7):e13781. doi: 10.1111/petr.13781. Epub 2020 Aug 13.

Abstract

IAH after RTX can threaten graft viability. This study aimed to assess the feasibility and safety of longitudinal IAP measurements as an IAH screening method in children after RTX. A cohort of eight children with a mean ± SD [range] age 9.6 ± 6.2 [2-17] years who underwent RTX and 18 control patients were evaluated between May 2017 and February 2018. We compared longitudinal IAP measurements using a Foley manometer to other clinical monitoring data. In total, 29 IAP measurements were performed in RTX patients and 121 in controls. The mean post-operative IAP was 7.4 ± 4.3 [1-16] mm Hg following RTX and 8.1 ± 3.7 [1-19] mm Hg in controls. We noted IAH in 9 (31%) of 29 IAP measurements after RTX and in 41 (34%) of 121 IAP measurements in controls. No graft dysfunction occurred in RTX patients despite elevated IAP values. The mean ± SD [range] time expenditure for IAP measurement was 2.1 ± 0.4 [0.6-3.2] minutes. No severe complications occurred during the IAP measurements. Analysis of longitudinal IAP measurements demonstrated that IAP measurement is safe and feasible in children recovering from renal transplantation in the PICU.

Keywords: IAH; IAP; PICU; intravesical pressure.

MeSH terms

  • Abdominal Cavity / physiopathology*
  • Adolescent
  • Child
  • Child, Preschool
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Intra-Abdominal Hypertension / diagnosis*
  • Intra-Abdominal Hypertension / etiology
  • Intra-Abdominal Hypertension / physiopathology
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / adverse effects*
  • Male
  • Manometry / methods
  • Monitoring, Physiologic / methods*
  • Postoperative Period
  • Pressure
  • Retrospective Studies