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Biancofiore G., Bindi M. L.
Transplantation and Postoperative Intensive Care Unit, Cisanello Hospital, University of Pisa, Pisa, Italy
Background. With this survey, we aimed at investigating the knowledge, recognition and management of intra-abdominal pressure (IAP) and abdominal hypertension (IAH) in Italian Intensive Care Units.
Methods. A questionnaire was sent to the “Intensive Care Unit lead physician” of 114 italian hospitals.
Results. One hundred fourteen questionnaires were sent, and 77 (67.5%) of them were returned completed. IAP was measured in 51 Units (66.3%). The most frequent reasons for not measuring IAP were the lack of a specific IAP monitoring kit (34.6%) and not knowing how to make the measurement (23.0%). Urinary bladder pressure was the only method used to measure IAP, the most frequent timing for IAP measurements was once every 4 h. An IAP value of 15 mmHg was considered to be the threshold for IAH in 33.4% of the cases, whereas in 31.4% of cases it was 20 mmHg. The presence of risk factors for IAH (64.7%) and a previous urgent surgery (21.5 %) were indicators of IAP monitoring. Diagnosis of IAH prompted a surgical consultation and evaluation, also in view of a possible abdominal decompression in 64.7 % of cases. More than half (54.9%, n=28) of the 51 ICUs where IAP was measured reported to be unaware of the World Society of the Abdominal Compartment Syndrome.
Conclusion. Italian intensive care unit physicians show a certain interest towards IAP monitoring and its implications in the management of critically ill patients. However, IAP, IAH and abdominal compartment syndrome still require greater basic understanding.