Awareness, knowledge and practices related to intra-abdominal hypertension and abdominal compartment syndrome among intensive care providers: a systematic scoping review.

IF 5.5 1区 医学 Q1 CRITICAL CARE MEDICINE
ZhiRu Li, FangYan Lu, JingYun Wu, YanHong Dai, Yan Wang, Li Zheng, HuaFen Wang
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引用次数: 0

Abstract

Objectives: To provide a comprehensive overview of current research on intensive care providers' awareness, knowledge, and practices regarding IAP/IAH/ACS, as well as barriers to IAP measurement.

Methods: This scoping review was guided by the framework of Arksey and Malley. Eight databases were searched to identify research published after 2007, including MEDLINE Complete, EMBASE, Web of Science, Cochrane Library, CINAHL Complete, ProQuest Health & Medical Complete, CNKI, and WANFANG. Two researchers reviewed and screened potentially relevant studies based on title and abstract. Full-text articles were independently assessed for eligibility based on predefined inclusion criteria.

Results: Nineteen articles were included. Overall, pediatric intensive care providers demonstrated a lower awareness and knowledge of IAH/ACS compared to adult intensive care providers, particularly regarding the consensus definitions of IAH/ACS in critically ill children. IAP measurement has not been adequately integrated into clinical practice, with 18.0-73.0% of intensive care providers reporting they have never measured it. The frequency of IAP measurements and the criteria for determining which patients necessitate such measurements exhibited significant variability across different hospitals. The most frequently mentioned barriers to IAP measurement include a lack of knowledge regarding IAP measurement among adult intensivists, an overreliance on physical examination among pediatric intensivists, uncertainty in interpreting IAP data among adult intensive care nurses, and challenges in identifying populations at high risk of IAH among pediatric intensive care nurses. Diuretics were mentioned most often in the management of IAH/ACS, followed by administration of vasopressors and inotropes, decompressive laparotomy, and judicious administration of fluids and blood products. 37.0-66.3% of adult intensivists would choose a decompressive laparotomy in cases of ACS, whereas pediatric intensivists were less inclined to opt for the same approach.

Conclusions: Since the publication of the WSACS consensus in 2007, there has been an improvement in awareness and knowledge regarding IAP/IAH/ACS among intensive care providers. Nevertheless, the understanding of the consensus definitions regarding IAH/ACS remains inadequate, particularly among pediatric intensive care providers. It is imperative to advocate for the implementation of WSACS guidelines in hospitals through targeted training programs and to promote the routine practice of IAP measurement in clinical settings.

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重症监护人员对腹内高血压和腹腔隔室综合征的认识、知识和实践:一项系统的范围审查。
目的:全面概述当前重症监护提供者对IAP/IAH/ACS的认识、知识和实践的研究,以及IAP测量的障碍。方法:本综述以Arksey和Malley的框架为指导。我们检索了MEDLINE Complete、EMBASE、Web of Science、Cochrane Library、CINAHL Complete、ProQuest Health & Medical Complete、CNKI和万方等8个数据库,以确定2007年以后发表的研究。两位研究者根据题目和摘要对可能相关的研究进行了回顾和筛选。根据预定义的纳入标准独立评估全文文章的合格性。结果:共纳入19篇文章。总体而言,与成人重症监护提供者相比,儿科重症监护提供者对IAH/ACS的认识和知识较低,特别是关于危重儿童IAH/ACS的共识定义。IAP测量尚未充分纳入临床实践,18.0-73.0%的重症监护提供者报告他们从未测量过IAP。IAP测量的频率和确定哪些患者需要进行此类测量的标准在不同医院之间表现出显著的差异。最常提到的IAP测量障碍包括:成人重症医师缺乏IAP测量知识,儿科重症医师过度依赖体格检查,成人重症护士IAP数据解释的不确定性,以及儿科重症护士在识别IAH高风险人群方面面临的挑战。在IAH/ACS的治疗中,利尿剂是最常被提及的,其次是血管加压剂和肌力药物的使用,减压剖腹手术,以及明智的液体和血液制品的使用。37.0-66.3%的成人重症医师会在ACS病例中选择减压剖腹手术,而儿科重症医师则不太倾向于选择相同的方法。结论:自2007年WSACS共识发表以来,重症监护提供者对IAP/IAH/ACS的认识和知识有所提高。然而,对IAH/ACS的共识定义的理解仍然不足,特别是在儿科重症监护提供者中。当务之急是通过有针对性的培训项目,倡导在医院实施WSACS指南,并在临床环境中促进IAP测量的常规做法。
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来源期刊
Annals of Intensive Care
Annals of Intensive Care CRITICAL CARE MEDICINE-
CiteScore
14.20
自引率
3.70%
发文量
107
审稿时长
13 weeks
期刊介绍: Annals of Intensive Care is an online peer-reviewed journal that publishes high-quality review articles and original research papers in the field of intensive care medicine. It targets critical care providers including attending physicians, fellows, residents, nurses, and physiotherapists, who aim to enhance their knowledge and provide optimal care for their patients. The journal's articles are included in various prestigious databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, OCLC, PubMed, PubMed Central, Science Citation Index Expanded, SCOPUS, and Summon by Serial Solutions.
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