Recognition and management of abdominal compartment syndrome in the United Kingdom

Tiwari, Alok; Myint, Fiona; Hamilton, George

doi:10.1007/s00134-006-0106-9

Cited by 49 publications

(35 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Not surprisingly, when it comes to the causes for IAH/ACS, our survey showed results similar to those published previously (Malbrain et al, 2006b;Tiwari et al, 2006), i.e., trauma, pancreatitis with massive fluid resuscitation, and liver cirrhosis with ascites. In massive bleeding, traditional aggressive crystalloid resuscitation is the most common risk factor associated with ACS, with a net positive fluid balance of 5 L over 24 h, resulting in 85% of the patients developing IAH in a recent study (Daugherty et al, 2007).…”

Section: Discussionsupporting

confidence: 89%

“…However, many things should also be taken into consideration with decompressive laparotomy, because the decompression could bring about massive intra-abdominal bleeding, persisting open abdomen, and subsequent extensive abdominal wall reconstruction. In our survey, similar to others (Ravishankar and Hunter, 2005;Tiwari et al, 2006), many respondents emphasized that they had very low surgical decompression rates even after the established diagnosis of ACS, because surgeons were reluctant to operate on those already very ill patients. The management of "open abdomen" and other complications including sepsis was challenging, because of a lack of awareness of the evolving management on the ACS for surgeons.…”

Section: Discussionsupporting

confidence: 74%

See 1 more Smart Citation

Current recognition and management of intra-abdominal hypertension and abdominal compartment syndrome among tertiary Chinese intensive care physicians

Zhou

Zhao

Pan

et al. 2011

J. Zhejiang Univ. Sci. B

View full text Add to dashboard Cite

This survey was designed to clarify the current understanding and clinical management of intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS) among intensive care physicians in tertiary Chinese hospitals. A postal twenty-question questionnaire was sent to 141 physicians in different intensive care units (ICUs). A total of 108 (76.6%) questionnaires were returned. Among these, three quarters worked in combined medical-surgical ICUs and nearly 80% had primary training in internal or emergency medicine. Average ICU beds, annual admission, ICU length of stay, acute physiology and chronic health evaluation (APACHE) II score, and mortality were 18.2 beds, 764.5 cases, 8.3 d, 19.4, and 21.1%, respectively. Of the respondents, 30.6% never measured intra-abdominal pressure (IAP). Although the vast majority of the ICUs adopted the exclusively transvesicular method, the overwhelming majority (88.0%) only measured IAP when there was a clinical suspicion of IAH/ACS and only 29.3% measured either often or routinely. Moreover, 84.0% used the wrong priming saline volume while 88.0% zeroed at reference points which were not in consistence with the standard method for IAP monitoring recommended by the World Society of Abdominal Compartment Syndrome. ACS was suspected mainly when there was a distended abdomen (92%), worsening oliguria (80%), and increased ventilatory support requirement (68%). Common causes for IAH/ACS were "third-spacing from massive volume resuscitation in different settings" (88%), "intra-abdominal bleeding", and "liver failure with ascites" (52% for both). Though 60% respondents would recommend surgical decompression when the IAP exceeded 25 mmHg, accompanied by signs of organ dysfunction, nearly three quarters of respondents preferred diuresis and dialysis. A total of 68% of respondents would recommend paracentesis in the treatment for ACS. In conclusion, urgent systematic education is absolutely necessary for most intensive care physicians in China to help to establish clear diagnostic criteria and appropriate management for these common, but life-threatening, diseases.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 74%

Current recognition and management of intra-abdominal hypertension and abdominal compartment syndrome among tertiary Chinese intensive care physicians

Zhou

Zhao

Pan

et al. 2011

J. Zhejiang Univ. Sci. B

View full text Add to dashboard Cite

show abstract

“…Die Ergebnisse der Umfrage legen nahe, dass das Problem verbreitet und bewusst ist, jedoch über die kausale Zuordnung zu einem Operationsverfahren Unklarheit herrscht. Das aktuellste systematische Review ermittelte Fistelraten von 2,9% ("abdominal dressing") [10,19,28]. Trotz zunehmender Bekanntheit des abdominellen Kompartmentsyndroms als chirurgisches Krankheitsbild ist vermutlich in UK das entsprechende Monitoring und Bewusstsein weiter verbreitet.…”

Section: Diskussionunclassified

Offenes Abdomen 2009

Herrle

Hasenberg

Fini

et al. 2011

Chirurg

View full text Add to dashboard Cite

show abstract

“…Diese Zahlen stimmen mit ausländischen Studien überein, in denen 72-98% der Befragten angaben, mit dem AKS vertraut zu sein [9,12,16,19]. Obwohl das Wissen über das AKS verbreitet ist, gibt ein Viertel der Teilnehmer der vorliegenden Studie an, den IAD nicht zu messen.…”

Section: Diskussionunclassified

“…So präsentieren die Ergebnisse dieser Untersuchung eher eine persönliche Einschätzung als objektive Befunde. Zusätzlich war die Antwortrate niedriger als die Raten zwischen 57 und 84%, die in den bereits angeführten Umfragen zu diesem Thema erzielt wurden [9,16,19]. Im Gegensatz zu diesen Untersuchungen gehörten die Befragten nicht zu einer überschaubaren spezifischen Gruppe von Spezialisten ( [9], Befragung von 102 Mitgliedern der Trauma Association of Canada), noch erfolgte die Einforderung fehlender Antworten.…”

unclassified