Division of Pediatric Critical Care, Department of Pediatrics, School of Medicine, Loma Linda University, 11175 Campus Street, Suite A1117, Loma Linda, CA 92354, USA.
Ann Intensive Care. 2012 Jul 5;2 Suppl 1(Suppl 1):S6. doi: 10.1186/2110-5820-2-S1-S6.
Abdominal compartment syndrome (ACS) is a syndrome associated with multi-system effects of elevated intra-abdominal pressure (IAP) in critically ill children. It has a 90-100% mortality rate if not recognized and treated promptly. Measuring IAP helps identify patients developing intra-abdominal hypertension (IAH) which allows for timely intervention before progression to ACS. IAP helps identify ACS and guides its medical and surgical management. IAP is often measured by the bedside nurse in the intensive care unit. Pediatric critical care nurses (PCCN) play a key role in managing critically ill patients and recognizing potential causes for clinical deterioration such as ACS therefore should be knowledgeable about this entity.
The aim of this study was to assess the awareness and current knowledge of ACS among PCCN.
A ten-item written questionnaire was distributed at a National Critical Care Conference in 2006 and again in 2010. Participants of the conference voluntarily completed and immediately returned the survey. Results from the two questionnaires were compared.
Sixty-two percent of 691 questionnaires were completed. The awareness of ACS improved from 69.3% in 2006 to 87.8% in 2010 (p < 0.001) among PCCN. "Years in practice" influenced awareness of ACS. Nurses working for 5-10 and > 10 years were, respectively, 2.34 and 1.89 times more likely to be aware of ACS than those working for < 5 years. Hands-on experience managing a child with ACS by PCCN also improved from 49.1% to 67.9% (p < 0.001) but remains low. The number of participants who never measured IAP fell from 27.3% to 19.1% (p = 0.101). The most common method being used to measure IAP is the bladder method. Knowledge of the definition of ACS remains poor with only 13.2% associating the definition of ACS with organ dysfunction in 2010 which was even lower than in 2006.
There is increasing awareness of ACS and experience in its management among PCCN. However, few PCCN correctly understand the definition of ACS. Since recognition of IAH and early intervention can reduce morbidity and mortality in critically ill patients, further educational efforts should be directed toward improving the knowledge and recognition of ACS by PCCN.
腹部间隔综合征（ACS）是一种与危重患儿腹腔内压力（IAP）升高相关的多系统效应综合征。如果不及时识别和治疗，其死亡率高达 90-100%。测量 IAP 有助于发现发生腹腔高压（IAH）的患者，从而在进展为 ACS 之前及时进行干预。IAP 有助于识别 ACS，并指导其医疗和手术管理。IAP 通常由重症监护病房的床边护士测量。儿科重症监护护士（PCCN）在管理危重患者和识别 ACS 等潜在临床恶化原因方面发挥着关键作用，因此应该了解这一实体。
本研究旨在评估 PCCN 对 ACS 的认识和当前知识水平。
2006 年在全国危重病会议上分发了一份十项内容的书面问卷，并于 2010 年再次分发。会议参与者自愿填写并立即返回调查。比较了两次问卷调查的结果。
691 份问卷中有 62%完成。2006 年 PCCN 对 ACS 的认识率为 69.3%，2010 年提高到 87.8%（p<0.001）。“从业年限”影响对 ACS 的认识。工作 5-10 年和>10 年的护士分别是工作<5 年的护士的 2.34 倍和 1.89 倍。PCCN 经手治疗 ACS 患儿的经验也从 49.1%提高到 67.9%（p<0.001），但仍然较低。从未测量过 IAP 的参与者人数从 27.3%下降到 19.1%（p=0.101）。最常用的测量 IAP 的方法是膀胱法。对 ACS 定义的了解仍然很差，只有 13.2%的人在 2010 年将 ACS 的定义与器官功能障碍联系起来，甚至低于 2006 年。
PCCN 对 ACS 的认识和管理经验有所增加。然而，很少有 PCCN 正确理解 ACS 的定义。由于识别 IAH 和早期干预可以降低危重患者的发病率和死亡率，因此应进一步努力提高 PCCN 对 ACS 的认识和识别能力。
