Background to our research work
Almost every critically ill child is at risk of developing intra-abdominal hypertension (IAH; increased pressure in the abdominal cavity) due to a disease of the abdominal cavity or systemic inflammation. This can lead to abdominal compartment syndrome (ACS), multi-organ failure or death via various mechanisms.
IAH is defined as an increase in intra-abdominal pressure (IAD) to over 10 mmHg; ACS is defined as the additional onset or aggravation of organ dysfunction. To date, three groups of factors have made adequate diagnosis and timely initiation of treatment difficult in the presence or development of IAH or ACS. These include
1. the limitations of quantification of intra-abdominal pressure (IAD) including the only moderate acceptance of regular IAD monitoring,
2. the lack of non-invasive monitoring options for micro- and macrocirculation, particularly under the suppressive influence of increased IAD, and
3. the hitherto unsuccessful search for laboratory chemical early warning parameters that can be used to detect the transition to IAD-induced organ dysfunction before ischemia- and possibly reperfusion-triggered inflammation can lead to the development of a potentially irreversible vicious circle with multi-organ failure and death.
Research priorities and objectives of the "pedACS" working group
The objectives of the "pedACS" working group are therefore:
- the validation and establishment of continuous IAD measurement methods that are superior to intermittent bladder pressure measurement as the previous pediatric gold standard and more practicable in everyday clinical practice.
- the establishment of a non-invasive monitoring concept for transcutaneous monitoring of micro- and macrocirculation under IAH/ACS and
- the identification of laboratory chemical biomarkers for the early detection of IAD-induced ischemia/reperfusion or organ damage
The data obtained should contribute to an earlier and more reliable diagnosis of critical restrictions of the micro- and macrocirculation under IAH/ACS and thereby reduce the prevalence, morbidity and mortality (60-100%).