الفهرس 
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Abstract
Intra-abdominal pressure (IAP) is the steady-state pressure concealed within the abdominal cavity. Increase IAP develops intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). ACS is a clinical complication associated with high mortality in children but increasing awareness and developing new strategies for management causing a decrease of mortality by nearly half in critically ill patients with this condition. Our study is an observational descriptive follow-up study with an analytical component. The study was carried out in the pediatric ICU unit, Mansoura University Children Hospital (MUCH) for 3 years (2017-2020) on all patients who were admitted to PICU in MUCH indwelling urinary catheter in place. It aimed to assess the prevalence, and risk factors of IAH in critically ill children in PICU. Out of 144 children were assessed for enrollment in the study, 141 children enrolled while 3 children were excluded due to short length of stay less than 24 hours. IAP was measured for all included patients on admission and every 6 hours and the following IAP on admission, worst IAP, and the patients were classified according to the presence of IAH, into two groups; one group with IAH and the other group without IAH, classification of the patients according to the severity of IAH into four grades according to WSACS On the measurement of IAP on admission, thirty-one (21.9%) patients had IAH, and 110 (78%) children did not have IAH, seventy-four out of 141 children had IAH (52.5%) while sixty-seven patients (47.5%) did not have IAH, the frequency of different grades of IAH was 20.6 %, 20.6 %, 9.2 %, 2.1 % for grades I, II, III, and IV respectively, only 21.6 % of IAH patients developed ACS and its incidence increases gradually with an increase in the grade of IAH which is a statistically significant difference with a p value (p <0.001). The mortality rate of all our studied cases is 57.5% while mortality was higher in those who had IAH as fifty out of the seventy-four who had IAH succumbed (67.6%) compared to thirty-one out of the sixty-seven children who did have IAH (46.3%) with a statistically significant difference with a p of value 0.01. Although there was no association between IAP on admission and survival among studied cases, the worst IAP was higher in non-survivors than survivors with a statistically significant difference with a p value of 0.008. Delta IAP was obtained by dividing worst IAP by IAP on admission and it correlated with PRISM, duration of mechanical ventilation, length of stay, and there was a statistically significant difference in the first three parameters with P value 0.016, 0.000, and 0.021 respectively. It was found that the percentage rise of the IAP level above the baseline value on admission (delta IAP) is a significant measure and more informative than the absolute value of IAP on admission.