Zhang Hua-Yu, Liu Dong, Tang Hao, Sun Shi-Jin, Ai Shan-Mu, Yang Wen-Qun, Jiang Dong-Po, Zhou Jian, Zhang Lian-Yang
Trauma Center, State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing 400042, China.
Chin J Traumatol. 2015;18(6):352-6. doi: 10.1016/j.cjtee.2015.11.015.
To investigate the prevalence and diagnosis rate of intra-abdominal hypertension (IAH) in a mixed-population intensive care unit (ICU), and to investigate the knowledge of ICU staff regarding the guidelines published by the World Society of Abdominal Compartment Syndrome (WSACS) in 2013.
A one-day cross-sectional study based on the WSACS 2013 guidelines was conducted in the general ICU of a tertiary teaching hospital in Chongqing, China. The included patients were divided into intravesical pressure (IVP) measured group and IVP unmeasured group. The epidemiologic data were recorded, and potential IAH risk factors (RFs) were collected based on the guidelines. IVP measurements were conducted by investigators every 4 h and the result was compared to that measured by the ICU staff to evaluate the diagnosis rate. Besides, a questionnaire was used to investigate the understanding of the guidelines among ICU staff.
Thirty-two patients were included, 14 in the IVP measured group and 18 in the IVP unmeasured group. The prevalence of IAH during the survey was 15.63% (5/32), 35.71% (5/14) in IVP measured group. Only one case of IAH had been diagnosed by the ICU physician and the diagnosis rate was as low as 20.00%. Logistic regression analysis showed that sequential organ failure assessment (SOFA) score was an independent RF for IAH (OR: 1.532, 95% CI: 1.029-2.282, p=0.036. Fourteen doctors and 5 nurses were investigated and the response rate was 67.86%. The average scores of the doctors and nurses were 27.14±20.16 and 16.00±8.94 respectively. None of them had studied the WSACS 2013 guidelines thoroughly.
Patients with a higher SOFA score has a higher incidence of IAH. The IAH prevalence in 14 ICU patients with indwelling catheter was 35.71%. Strengthening the wide and rational use of WSACS guideline is important to improve the diagnosis of IAH.
调查综合重症监护病房（ICU）中腹内高压（IAH）的患病率及诊断率，并调查ICU医护人员对世界腹腔间隔室综合征协会（WSACS）2013年发布指南的了解情况。
在中国重庆一家三级教学医院的综合ICU进行了一项基于WSACS 2013年指南的单日横断面研究。纳入患者分为膀胱内压（IVP）测量组和IVP未测量组。记录流行病学数据，并根据指南收集潜在的IAH危险因素（RFs）。研究人员每4小时进行一次IVP测量，并将结果与ICU医护人员测量的结果进行比较，以评估诊断率。此外，使用问卷调查ICU医护人员对指南的理解情况。
共纳入32例患者，IVP测量组14例，IVP未测量组18例。调查期间IAH患病率为15.63%（5/32），IVP测量组为35.71%（5/14）。ICU医生仅诊断出1例IAH，诊断率低至20.00%。逻辑回归分析显示，序贯器官衰竭评估（SOFA）评分是IAH的独立危险因素（OR：1.532，95%CI：1.029 - 2.282，p = 0.036）。对14名医生和5名护士进行了调查，回复率为67.86%。医生和护士的平均得分分别为27.14±20.16和16.00±8.94。他们中没有人对WSACS 2013年指南进行过深入研究。
SOFA评分较高的患者IAH发病率较高。14例留置导管的ICU患者中IAH患病率为35.71%。加强WSACS指南的广泛合理应用对提高IAH的诊断至关重要。
