Study of intra-abdominal hypertension prevalence and awareness level among experienced ICU medical staff

Background: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).Methods:A 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.Results:Forty-one patients were selected.Fifteen(36.59%) had IVP?12mm Hg.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).Conclusion:The 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.

Prevalence and diagnosis rate of intra-abdominal hypertension in critically ill adult patients： A single-center cross-sectional study

Purpose： To investigate the prevalence and diagnosis rate of intra-abdominal hypertension （IAH） in a mixed-population intensive care unit （ICU）, and to investigate the knowledge of ICU staff regarding the guidelines published by the World Society of Abdominal Compartment Syndrome （WSACS） in 2013. Methods： A one-day cross-sectional study based on the WSACS 2013 guidelines was conducted in the general ICU of a tertiary teaching hospital in Chongqing, China. The included patients were divided into intravesical pressure （IVP） measured group and IVP unmeasured group. The epidemiologic data were recorded, and potential IAH risk factors （RFs） were collected based on the guidelines. IVP measurements were conducted by investigators every 4 h and the result was compared to that measured by the ICU staff to evaluate the diagnosis rate. Besides, a questionnaire was used to investigate the understanding of the guidelines among ICU staff. Results： Thirty-two patients were included, 14 in the IVP measured group and 18 in the IVP unmeasured group. The prevalence of IAH during the survey was 15.63% （5/32）, 35.71% （5/14） in IVP measured group. Only one case of IAH had been diagnosed by the ICU physician and the diagnosis rate was as low as 20.00%. Logistic regression analysis showed that sequential organ failure assessment （SOFA） score was an independent RF for IAH （OR： 1.532, 95Yg CI： 1.029-2.282, p- 0.036. Fourteen doctors and 5 nurses were investigated and the response rate was 67.86%. The average scores of the doctors and nurses were 27.14 ± 20.16 and 16.00 ± 8.94 respectively. None of them had studied the WSACS 2013 guidelines thoroughly. Conclusion： Patients with a higher SOFA score has a higher incidence of IAH. The IAH prevalence in 14 ICU patients with indwelling catheter was 35.71%. Strengthening the wide and rational use of WSACS guideline is important to improve the diagnosis of IAH.