Nagappan R, Ernest D, Whitfield A
Intensive Care Unit, Box Hill Hospital, Box Hill, Victoria.
Crit Care Resusc. 2005 Dec;7(4):298-302.
To determine ICU registrars' level of awareness regarding measurement of intra-abdominal pressure (IAP), features of intra-abdominal hypertension (IAH), and management of abdominal compartment syndrome (ACS).
We surveyed 40 Australasian ICU registrars attending a post-graduate teaching course in 2004. The survey questions explored clinical experience and understanding of IAP, methods of measurement of IAP, diagnosis and causes of IAH and management of ACS in critically ill patients.
The survey recorded a 90% response rate. Ninety two percent of the ICU registrars had used IAP in their clinical practice; 52% of those with experience in IAP measurement had only employed it infrequently. While 90% affirmed their knowledge that IAP can rise due to intraperitoneal pathology, causation of IAH by retroperitoneal conditions was poorly understood. Ninety two per cent correctly said that ACS should be treated by abdominal decompression. Only 70% of our respondents felt confident not to perform a computed tomography (CT) scan of the abdomen before treating a patient with ACS. The majority understood the need for, and the modes of, therapy for ACS; but 33 % erroneously said that they would treat IAP > 30 mmHg regardless of organ dysfunction and another 22 % were unsure of the threshold of therapy for ACS.
ICU registrars in Australasia appreciate the techniques for, and significance of, IAP measurements and recognise and treat ACS appropriately. Retroperitoneal causes of IAH and the threshold for treatment for ACS were not well understood by the respondents.
确定重症监护病房（ICU）住院医生对腹腔内压力（IAP）测量、腹腔高压（IAH）特征以及腹腔间隔室综合征（ACS）管理的认知水平。
我们对2004年参加研究生教学课程的40名澳大利亚和新西兰ICU住院医生进行了调查。调查问题探讨了他们在IAP方面的临床经验和理解、IAP的测量方法、IAH的诊断和病因以及危重病患者ACS的管理。
调查的回复率为90%。92%的ICU住院医生在临床实践中使用过IAP；在有IAP测量经验的人中，52%只是偶尔使用。虽然90% 的人确认他们知道IAP可因腹膜内病变而升高，但对腹膜后情况导致IAH的原因了解不足。92%的人正确表示ACS应通过腹腔减压治疗。在治疗ACS患者之前，只有70%的受访者有信心不进行腹部计算机断层扫描（CT）。大多数人理解ACS治疗的必要性和治疗方式；但33%的人错误地表示，无论器官功能障碍如何，他们都会治疗IAP>30 mmHg，另外22%的人不确定ACS的治疗阈值。
澳大利亚和新西兰的ICU住院医生了解IAP测量的技术和意义，并能正确识别和治疗ACS。受访者对IAH的腹膜后病因和ACS的治疗阈值了解不足。
