Table 1 Comparison between results of current surveys related to IAH and ACS
Authors | Reference | Awareness of ACS | Yearly frequency of AS at ICUs | Performance of IAP measurements | Basis of IAH/ACS diagnosis | Measure method | Frequency of measurements | Threshold IAH | Threshold ACS | Experience with/opinion about DL and OA |
|---|---|---|---|---|---|---|---|---|---|---|
Mayberry et al. | [9] | 85% | 14%: No cases | 69% to 95% | 66% IAP measure | IVP | 59% If suspected | 15 mmHg (11%) | 86%: DL if IAH + OD (= ACS) | |
52%: One to five cases | 34% Clinical | 6% Regularly | 18 mmHg (22%) | 14%: DL if IAH alone | ||||||
33%: Five cases | 22 mmHg (31%) | If OA: Bag > absorb. Mesh > non-absorb. Mesh | ||||||||
25 mmHg (12%) | ||||||||||
Kirkpatrick et al. | [10] | 100% | 52% | 43% IAP measure | 97% IVP | 25 mmHg + OD | 8%: DL if IAH alone | |||
3% IGP | 34 mmHg - OD | 90% OA after trauma surgery | ||||||||
If OA: Bag > VAC > non-absorb. > absorb. Mesh | ||||||||||
Ravishankar and Hunter | [4] | 99% | 76% | 76% IAP measure | IVP | 93% If suspected | 20 mmHg (29%) | 2%: DL if IAP > 20 mmHg alone (= IAH III) | ||
24% Clinical | 4% After EL | 25 mmHg (71%) | 27%: DL if IAP > 20 mmHg + OD (= ACS) | |||||||
3% After EL + HVR | 7%: DL if IAP > 25 mmHg alone (= IAH IV) | |||||||||
15%: Zero to four hourly | 64%: DL if IAP > 25 mmHg + OD (= ACS) | |||||||||
27%: Four to eight hourly | ||||||||||
11%: 12 hourly | ||||||||||
3%: 24 hourly | ||||||||||
Nagappan et al. | [14] | 92% | 'Depending on used thresholds'; ICU-dependent | 48% to 93% | 8% Clinical | 89% IVP | 8% Never | 12 mmHg (11%) | IAH + OD (69%) | 92%: ACS = decompression (ever) |
39% Direct | 53% Rarely | 20 mmHg (64%) | ≥30 mmHg - OD (33%) | 64%: 'ACS should be treated regardless of IAH' | ||||||
6% IGP | 19% Regularly | |||||||||
6% IRP | 25% Often | |||||||||
Tiwari et al. | [2] | 73% to 97% | 74% to 94% IAP measure | 90% to 96% IVP | 11 to 30 mmHg (teaching hospit.) | 42% Performed DL in 0% to 25% of ACS patients | ||||
60% to 77% Clinical | 4% to 10% Direct | 11 to 50 mmHg (district hospital) | 19% Performed DL in 25% to 50% of ACS patients | |||||||
3% to 12% CT scan | 16% Performed DL in 50% to 75% of ACS patients | |||||||||
3% pH manometry | 23% Performed DL in 75% to 100% of ACS patients | |||||||||
Kimball et al. | [15] | 75% to 98% | 17%: No cases | 76% to 98% | 70% IAP + clinical | IVP | 47% Seldom | 'Patient dependent' | 20 to 27 mmHg (42%) | 'Useful invasive therapy options': |
39%: One to three cases | 20% Clinical | 23% Often | 12 to 19 mmHg (18% to 25%) | -Decompressive laparotomy | ||||||
27%: Four to seven cases | 7% IAP measure | 8% Routinely | 12 to 19 mmHg (18% to 25%) | -Paracentesis/drains | ||||||
10%: Eight to 10 cases | 3% Others | 1% Other | -Escharatomy/fasciotomy | |||||||
8%: > Ten cases | -Peritoneal dialysis (catheter) | |||||||||
De Laet et al. | [12] | 80% | 41% | 51% IAP measure | 'Majority' IVP | 59% Never | 15 mmHg (IQR 12 to 15) | 20 mmHg (IQR 20 to 20) | 75% Performed at least one DL | |
49% Clinical | 28% If suspected | 60% Performed at least one OA | ||||||||
12% Continuously | If OA: Bag > abs. > VAC > gauze > non-absorb. | |||||||||
Ejike et al. | [13] | 76% | 76% IAP measure | 68% IVP | 27% Never | |||||
24% Clinical | 13% Direct | |||||||||
+/- Doppler | ||||||||||
+/- IGP | ||||||||||
Zhou et al. | [16] | 0%: No cases | 69% | 31% Clinical | 100% IVP | 88% If suspected | 25 mmHg | 68%: First-line therapy paracentesis | ||
44%: One to three cases | 7% CVP | 71% Seldom | 56%: DL if IAP > 25 mmHg + OD (= ACS) | |||||||
16%: Four to seven cases | 29% Regularly | |||||||||
8%: Eight to ten cases | 8% After EL | |||||||||
32%: > Ten cases | 4% After HVR | |||||||||
Kaussen et ala | 95% | 6%: Never | 75% | 26% Clinical | 94% IVP | 40% If suspected | 20 mmHg (43%) | 4%: DL if IAP > 20 mmHg alone (= IAH III) | ||
64%: Seldom | 6% IGP | 4%: Zero to four hourly | 25 mmHg (57%) | 39%: DL if IAP > 20 mmHg + OD (= ACS) | ||||||
24%: Regularly | 22%: Four to eight hourly | 10%: DL if IAP > 25 mmHg alone (= IAH IV) | ||||||||
6%: Often | 7%: 12 hourly | 46%: DL if IAP > 25 mmHg + OD (= ACS) | ||||||||
2%: 24 hourly | ||||||||||
Malbrain et al. | [11] | 99% | 0.3%: No cases | 86% | 69% IAP + clinical | 92% IVP | 42% If suspected | 5 mmHg (< 1%) | 20 mmHg (27%) | 74%: DL if IAH + OD |
4% Continuously | ||||||||||
62%: One to five cases | 24% IAP measure | 4% Direct | 32% Four hourly | 10 mmHg (6%) | 25 mmHg (12%) | 9%: DL if severe OD (even without IAH) | ||||
20%: Six to ten cases | 13% CT scan | 3% IGP | 26% Six to eight hourly | 12 mmHg (18%) | > 25 mmHg (58%) | 6%: DL dependent on cause of ACS | ||||
6%: 11 to 15 Cases | 10% Abdom. perimeter | 6% 12 hourly | 15 mmHg (25%) | If OA: VAC (39%) > Bag (24%) > mesh (21%) | ||||||
5%: 16 to 20 cases | 8% Abdom. ultrasound | 2% 24 hourly | 20 mmHg (29%) | |||||||
6%: > 25 Cases | 25 mmHg (5%) | |||||||||
> 25 mHg (15%) | ||||||||||
Others (2%) | ||||||||||
Newcombe et al. | [38] | 88% | 92% | 83% IAP measure | 93% IVP | 21% Regularly | ≤15 mmHg (11%) | |||
8% IAP + clinical | 7% Direct | 54% Sometimes | ≤25 mmHg (59%) | |||||||
7% Clinical | 0% IGP | 19% Never | > 25 mmHg (30%) |