Recognition and management of intra-abdominal hypertension and abdominal compartment syndrome; a survey among Dutch surgeons

Autor: Michael H.J. Verhofstad, Roelof A. Verhoeven, Steven G. Strang, Oscar J.F. Van Waes, Esther M.M. Van Lieshout
Přispěvatelé: Surgery
Rok vydání: 2017
Předmět:
medicine.medical_specialty
Abdominal compartment syndrome
Sports medicine
medicine.medical_treatment
Computer-assisted web interviewing
Critical Care and Intensive Care Medicine
03 medical and health sciences
0302 clinical medicine
Risk Factors
Laparotomy
Surveys and Questionnaires
medicine
Humans
Orthopedics and Sports Medicine
Practice Patterns
Physicians'
Intensive care medicine
Open abdomen
Netherlands
Intra-abdominal pressure
Evidence-Based Medicine
business.industry
Questionnaire
General surgery
030208 emergency & critical care medicine
Evidence-based medicine
medicine.disease
Intra-abdominal hypertension
Management
030220 oncology & carcinogenesis
Practice Guidelines as Topic
Emergency Medicine
Surgery
Original Article
Guideline Adherence
Intra-Abdominal Hypertension
Complication
business
Zdroj: European Journal of Trauma and Emergency Surgery
European Journal of Trauma and Emergency Surgery, 43(1), 85-98. Springer International Publishing AG
ISSN: 1863-9941
1863-9933
Popis: Purpose Intra-abdominal hypertension (IAH) and Abdominal compartment syndrome (ACS) are relatively rare, but severe complications. Although many advances were made in recent years, the recognition and management remain subject of debate. The aim of this study was to determine the current state of awareness, knowledge and use of evidence-based medicine regarding IAH and ACS among Dutch surgeons. Methods A literature-based and expert consensus survey was developed. One surgeon in every hospital in The Netherlands was asked to complete the online questionnaire. Results Sixty of 87 (69 %) invited surgeons completed the questionnaire. Intra-abdominal pressure (IAP) was measured using intra-vesical methods by 55 (98 %) respondents. Diuretics (N = 38; 63 %) and laparotomy (N = 33; 55 %) were considered useful treatments for IAH or prevention of ACS by a majority. Only 16 (27 %) respondents used these guidelines in daily practice, and 37 (62 %) respondents are willing to do so. Although 35 (58 %) surgeons agreed that IAH is only a symptom, not requiring treatment. Forty-one percent of experienced respondents suggested that prevalence of ACS remained unchanged. Nearly all respondents (N = 59; 98 %) believed that open abdomen management improves patient outcomes, many (N = 46; 77 %) confirm the high complications rate of this treatment. Conclusion The definitions of IAH and ACS and the related diagnostic and therapeutic challenges are relatively well known by Dutch surgeons. Despite limited use of the evidence-based guidelines, the willingness to do so is high. Most respondents favor open abdomen treatment for patients with imminent ACS, despite the high complication rates associated with this treatment.
Databáze: OpenAIRE
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