Abstract
BackgroundIntra-abdominal hypertension (IAH) is a disease with high morbidity and mortality among critically ill patients. The study’s objectives were to explore the prevalence of IAH and physicians’ awareness of the 2013 World Society of Abdominal Compartment Syndrome (WSACS) guidelines in Chinese intensive care units (ICUs).MethodsA cross-sectional study of four ICUs in Southwestern China was conducted from June 17 to August 2, 2014. Adult patients admitted to the ICU for more than 24 h, with bladder catheter but without obvious intravesical pressure (IVP) measurement contraindications, were recruited. Intensivists with more than 5 years of ICU working experience were also recruited. Epidemiological information, potential IAH risk factors, IVP measurements and questionnaire results were recorded.ResultsForty-one patients were selected. Fifteen (36.59 %) had IVP ≥ 12 mmHg. SOFA (Sequential Organ Failure Assessment) hepatic and neurological sub-scores were utilized as independent predictors for IAH via logistic backward analysis. Thirty-seven intensivists participated in the survey (response rate: 80.43 %). The average score of each center was less than 35 points. All physicians believed the IAH prevalence in their departments was no more than 20.00 %. A significant negative correlation was observed between the intensivists’ awareness of the 2013 WSACS guidelines and the IAH prevalence in each center (r = -0.975, P = 0.025).ConclusionsThe prevalence and independent predictors of IAH among the surveyed population are similar to the reports in the literature. Intensivists generally have a low awareness of the 2013 WSACS guidelines. A systematic guideline training program is vital for improving the efficiency of the diagnosis and treatment of IAH.
Highlights
Intra-abdominal hypertension (IAH) is a disease with high morbidity and mortality among critically ill patients
Epidemiological studies have found a high prevalence of IAH among critically ill intensive care unit (ICU) patients [4] and have shown that the occurrence of IAH is an independent predictor of mortality [5]
The 2013 World Society of Abdominal Compartment Syndrome (WSACS) guidelines follow the former definitions of IAH and abdominal compartment syndrome (ACS), extend new concepts such as abdominal compliance, and evaluate the treatment strategy based on the Grading of recommendations (GRADE) (Grading of Recommendations, Assessment, Development, and Evaluation) system [9]
Summary
Intra-abdominal hypertension (IAH) is a disease with high morbidity and mortality among critically ill patients. The study’s objectives were to explore the prevalence of IAH and physicians’ awareness of the 2013 World Society of Abdominal Compartment Syndrome (WSACS) guidelines in Chinese intensive care units (ICUs). Scholars have long studied the effects of intra-abdominal pressure (IAP) on human physiological functions [1]. Epidemiological studies have found a high prevalence of IAH among critically ill intensive care unit (ICU) patients [4] and have shown that the occurrence of IAH is an independent predictor of mortality [5]. Before the publication of the first-edition guideline by the WSACS in 2006 [6], there was no consensus among scholars regarding the diagnostic criteria for IAH and ACS, the standard IAP measurement protocol, or the treatment strategy. ICU physicians attach importance to IAH, their implementation of the guidelines is not satisfactory [10]
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