ABSTRACT 651

Abstract

Background and aims: Several decades ago, the beneficial effects of goal-directed therapy in cases of intra-abdominal hypertension (IAH), were proven in the context of closures of abdominal-wall-defects and large-for-size transplantations. Different neonatologic and pediatric disease patterns are also known to increase intra-abdominal pressure (IAP). Nevertheless, a considerable knowledge transfer regarding such risk factors has hardly taken place. When left untreated, IAH threatens to evolve into abdominal compartment syndrome (ACS), which is accompanied by a mortality rate of 60% in children. Aims: Therefore, the present study looks at the recognition and knowledge of IAH/ACS among Alpine pediatric intensivists. Methods: In June 2010, a questionnaire was mailed to the heads of pediatric intensive care units of 85 Austrian and Swiss pediatric hospitals. Results: Response rate was 34%. At least one case of IAH was reported by 29% of respondents; at least one case of ACS, by 20%. Compared with adolescents, younger children appeared to develop IAH/ACS more often. Routine measurements of IAP were said to be performed by 26% of respondents. Bladder pressure was used most frequently to assess IAP. In 2009, 8% of respondents claimed to have performed a DL. Surgical decompression was indicated if signs of organ dysfunction were present or if an IAP of 15 mmHg was surpassed. Conclusions: Although awareness among pediatricians has increased over the last decade, definitions and guidelines regarding diagnosis and management of IAH/ACS are not applied uniformly. This variability could express an ever present lack of awareness and solid prospective data.