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Open Access 01-12-2024 | Abdominal Compartment Syndrome | Research

International cross-sectional survey on current and updated definitions of intra-abdominal hypertension and abdominal compartment syndrome

Authors: Prashant Nasa, Robert D. Wise, Marije Smit, Stefan Acosta, Scott D’Amours, William Beaubien–Souligny, Zsolt Bodnar, Federico Coccolini, Neha S. Dangayach, Wojciech Dabrowski, Juan Duchesne, Janeth C. Ejike, Goran Augustin, Bart De Keulenaer, Andrew W. Kirkpatrick, Ashish K. Khanna, Edward Kimball, Abhilash Koratala, Rosemary K. Lee, Ari Leppaniemi, Edgar V. Lerma, Valerie Marmolejo, Alejando Meraz–Munoz, Sheila N. Myatra, Daniel Niven, Claudia Olvera, Carlos Ordoñez, Clayton Petro, Bruno M. Pereira, Claudio Ronco, Adrian Regli, Derek J. Roberts, Philippe Rola, Michael Rosen, Gentle S. Shrestha, Michael Sugrue, Juan Carlos Q. Velez, Ron Wald, Jan De Waele, Annika Reintam Blaser, Manu L. N. G. Malbrain

Published in: World Journal of Emergency Surgery | Issue 1/2024

Abstract

Background

The Abdominal Compartment Society (WSACS) established consensus definitions and recommendations for the management of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in 2006, and they were last updated in 2013. The WSACS conducted an international survey between 2022 and 2023 to seek the agreement of healthcare practitioners (HCPs) worldwide on current and new candidate statements that may be used for future guidelines.

Methods

A self-administered, online cross-sectional survey was conducted under the auspices of the WSACS to assess the level of agreement among HCPs over current and new candidate statements. The survey, distributed electronically worldwide, collected agreement or disagreement with statements on the measurement of intra-abdominal pressure (IAP), pathophysiology, definitions, and management of IAH/ACS. Statistical analysis assessed agreement levels, expressed in percentages, on statements among respondents, and comparisons between groups were performed according to the respondent’s education status, base specialty, duration of work experience, role (intensivist vs non-intensivist) and involvement in previous guidelines. Agreement was considered to be reached when 80% or more of the respondents agreed with a particular statement.

Results

A total of 1042 respondents from 102 countries, predominantly physicians (73%), of whom 48% were intensivists, participated. Only 59% of HCPs were aware of the 2013 WSACS guidelines, and 41% incorporated them into practice. Despite agreement in most statements, significant variability existed. Notably, agreement was not reached on four new candidate statements: “normal intra-abdominal pressure (IAP) is 10 mmHg in critically ill adults” (77%), “clinical assessment and estimation of IAP is inaccurate” (65.2%), “intragastric can be an alternative to the intravesical route for IAP measurement” (70.4%), and “measurement of IAP should be repeated in the resting position after measurement in a supine position” (71.9%). The survey elucidated nuances in clinical practice and highlighted areas for further education and standardization.

Conclusion

More than ten years after the last published guidelines, this worldwide cross-sectional survey collected feedback and evaluated the level of agreement with current recommendations and new candidate statements. This will inform the consensus process for future guideline development.

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Title: International cross-sectional survey on current and updated definitions of intra-abdominal hypertension and abdominal compartment syndrome
Authors: Prashant Nasa
Robert D. Wise
Marije Smit
Stefan Acosta
Scott D’Amours
William Beaubien–Souligny
Zsolt Bodnar
Federico Coccolini
Neha S. Dangayach
Wojciech Dabrowski
Juan Duchesne
Janeth C. Ejike
Goran Augustin
Bart De Keulenaer
Andrew W. Kirkpatrick
Ashish K. Khanna
Edward Kimball
Abhilash Koratala
Rosemary K. Lee
Ari Leppaniemi
Edgar V. Lerma
Valerie Marmolejo
Alejando Meraz–Munoz
Sheila N. Myatra
Daniel Niven
Claudia Olvera
Carlos Ordoñez
Clayton Petro
Bruno M. Pereira
Claudio Ronco
Adrian Regli
Derek J. Roberts
Philippe Rola
Michael Rosen
Gentle S. Shrestha
Michael Sugrue
Juan Carlos Q. Velez
Ron Wald
Jan De Waele
Annika Reintam Blaser
Manu L. N. G. Malbrain
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Abdominal Compartment Syndrome
Hypertension
Hypertension
Published in: World Journal of Emergency Surgery / Issue 1/2024
Electronic ISSN: 1749-7922
DOI: https://doi.org/10.1186/s13017-024-00564-5

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International cross-sectional survey on current and updated definitions of intra-abdominal hypertension and abdominal compartment syndrome

Abstract

Background

Methods

Results

Conclusion

Other articles of this Issue 1/2024

Ultrasonic dissection versus electrocautery dissection in laparoscopic cholecystectomy for acute cholecystitis: a randomized controlled trial (SONOCHOL-trial)

Efficacy of direct-to-operating room trauma resuscitation: a systematic review

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Abstract

Background

Methods

Results

Conclusion

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Ultrasonic dissection versus electrocautery dissection in laparoscopic cholecystectomy for acute cholecystitis: a randomized controlled trial (SONOCHOL-trial)

Efficacy of direct-to-operating room trauma resuscitation: a systematic review

Association of initial lactate levels and red blood cell transfusion strategy with outcomes after severe trauma: a post hoc analysis of the RESTRIC trial

International Delphi consensus on the management of percutaneous choleystostomy in acute cholecystitis (E-AHPBA, ANS, WSES societies)

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