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Table 1 Comparison between results of current surveys related to IAH and ACS

From: Recognition and management of abdominal compartment syndrome among German anesthetists and surgeons: a national survey

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%)  
  1. absorb., absorbable (mesh); abdom., abdominal; ACS, abdominal compartment syndrome; AustAsia, Australia and Asia (Australasia); Bag, 'bowel bag' such as 'Bogota bag'; CVP, central venous pressure measurement; direct, intra-abdominal pressure measurement via intra-abdominal placed probes; DL, decompressive laparotomy; EL, emergeny laparotomy; hospit., hospital; HVR, high-volume resuscitation; IAH, intra-abdominal hypertension; IAP, intra-abdominal pressure; ICU, intensive care unit; IGP, intra-gastric pressure measurement; IQR, inter-quartile range; IRP, intra-rectal pressure measurement; IVP, intra-vesical (bladder) pressure measurement; non-absorb., non-absorbable (mesh); OA, open abdomen management; OD, organ dysfunction/failure; VAC, vacuum-assisted. aUnpublished work.