Splanchnic perfusion pressure

a better predictor of safe primary closure than intraabdominal pressure in neonatal gastroschisis

Rebecca M. McGuigan, Philip S. Mullenix, Ravindra Vegunta, Richard H. Pearl, Robert Sawin, Kenneth Azarow

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background/Purpose: Both measured intraabdominal pressure (IAP) and calculated splanchnic perfusion pressure (SPP) have been advocated for use in operative management of gastroschisis. We directly compared these 2 clinical indices. Methods: Institutional review board-approved multi-institutional retrospective review from 3 centers with 112 subjects. Splanchnic perfusion pressure was recorded as mean arterial pressure-IAP. We compared the clinical utility of IAP and SPP using univariate and multivariate regression analyses. Results: Calculated mean SPP was higher among neonates requiring silo placement compared to those without (39.0 ± 1.9 vs 33.7 mm Hg, P <.01). Measured IAP levels were similar between groups (11.5 ± 1.1 vs 10.0 ± 0.5, mm Hg, P <.4). On a receiver operating characteristic curve, the inflection point for more than 90% specificity for silo placement was at an SPP of 44. In multivariate regression analysis adjusting for all factors below, SPP was independently associated with silo placement (odds ratio 1.2, 95% confidence interval 1.1-1.3, P <.01), and IAP was not (odds ratio 1.2, 95% confidence interval

Original languageEnglish (US)
Pages (from-to)901-904
Number of pages4
JournalJournal of Pediatric Surgery
Volume41
Issue number5
DOIs
StatePublished - May 2006
Externally publishedYes

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Gastroschisis
Viscera
Perfusion
Pressure
Multivariate Analysis
Odds Ratio
Regression Analysis
Confidence Intervals
Research Ethics Committees
ROC Curve
Arterial Pressure

Keywords

  • Abdominal pressure
  • Abdominal wall defect
  • Gastric pressure
  • Gastroschisis
  • Perfusion pressure

ASJC Scopus subject areas

  • Surgery

Cite this

Splanchnic perfusion pressure : a better predictor of safe primary closure than intraabdominal pressure in neonatal gastroschisis. / McGuigan, Rebecca M.; Mullenix, Philip S.; Vegunta, Ravindra; Pearl, Richard H.; Sawin, Robert; Azarow, Kenneth.

In: Journal of Pediatric Surgery, Vol. 41, No. 5, 05.2006, p. 901-904.

Research output: Contribution to journalArticle

McGuigan, Rebecca M. ; Mullenix, Philip S. ; Vegunta, Ravindra ; Pearl, Richard H. ; Sawin, Robert ; Azarow, Kenneth. / Splanchnic perfusion pressure : a better predictor of safe primary closure than intraabdominal pressure in neonatal gastroschisis. In: Journal of Pediatric Surgery. 2006 ; Vol. 41, No. 5. pp. 901-904.
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