Ravishankar N, Hunter J
Department of Anaesthetics and Intensive Care, Gloucester Royal Hospital, Gloucester GL1 3NN, UK.
Br J Anaesth. 2005 Jun;94(6):763-6. doi: 10.1093/bja/aei117. Epub 2005 Mar 11.
To explore the attitudes of intensivists in the UK to intra-abdominal pressure (IAP) measurement and abdominal compartment syndrome (ACS) and to determine current practice.
A postal questionnaire study addressed to the lead clinician in the intensive care unit was sent to hospitals in the UK with a general surgical service.
Completed questionnaires were received from 137 of the 207 hospitals surveyed (66.2% response rate). Only 1.5% of the respondents (n=2) had no prior knowledge of intra-abdominal hypertension and ACS. IAP had been measured on some occasion by 75.9% (n=104) of the respondents, always by the intravesical route. Among those intensive care units that measured IAP, in 93.2% (n=97) it was only measured when there was a suspicion of the development of ACS; 3.8% of units (n=4) measured IAP on all patients who had undergone an emergency laparotomy, and 2.9% (n=3) measured IAP only in those who had undergone emergency laparotomy associated with massive fluid resuscitation. There was major disparity in the frequency of IAP measurement and when to recommend abdominal decompression.
Despite widespread awareness of IAH and the ACS, many intensive care units never measure the IAP. When it is measured, the intravesical route is used exclusively. No consensus exists on optimal timing of measurement or when decompressive laparotomy should be performed.
探讨英国重症监护医生对腹腔内压力（IAP）测量及腹腔间隔室综合征（ACS）的态度，并确定当前的实践情况。
向英国设有普通外科服务的医院的重症监护病房的主治医生发送了一份邮政问卷调查。
在207家被调查医院中，有137家（回复率66.2%）返回了完整问卷。只有1.5%的受访者（n = 2）对腹腔内高压和ACS毫无了解。75.9%的受访者（n = 104）曾在某些情况下测量过IAP，均采用膀胱内途径。在那些测量IAP的重症监护病房中，93.2%（n = 97）仅在怀疑发生ACS时才进行测量；3.8%的病房（n = 4）对所有接受急诊剖腹手术的患者测量IAP，2.9%（n = 3）仅对那些接受与大量液体复苏相关的急诊剖腹手术的患者测量IAP。在IAP测量频率及何时建议进行腹腔减压方面存在很大差异。
尽管对IAH和ACS有广泛认知，但许多重症监护病房从未测量过IAP。测量时，仅采用膀胱内途径。在测量的最佳时机或何时应进行减压剖腹手术方面尚无共识。
