| Abstract: Aims
Abdominal compartment syndrome is increasingly being recognised as a cause of significant morbidity and mortality(1,2). In the U.K., no study has looked at the prevalence, causes, diagnosis and treatment of this condition. We conducted a questionnaire study of all Intensive care units in the United Kingdom to look at this condition.
Method
A postal questionnaire was sent to 222 intensive care units dealing with acute abdominal conditions. A pre-paid envelope was included.
Results
96 questionnaires have been returned so far (22 from academic institutions and 74 from district general hospitals (DGHs)). 21/22(95%) academic institutions recognised patients with ACS whilst only 54/74(73%) saw this condition in DGHs . The causes of this condition in academic institutions were small and large bowel surgery, vascular surgery, hepatobiliary surgery and following trauma. In the DGH causes were small and large bowel surgery, trauma and vascular surgery. ACS was suspected where there was a distended abdomen, oliguria and increased ventilatory support. Diagnosis was confirmed clinically or by measuring intravesical pressure. The pressure threshold for diagnosing the condition was variable. Plastic bag or a vacuum packing was the most common method of covering the abdomen after decompression. There was a large variation in the number of patients who were actually decompressed following diagnosis.
Discussion
In the U.K. many district general hospitals do not seem to see any cases of ACS reflecting either a genuine lack of patients with this condition or lack of awareness. The common causes are small and large bowel surgery, trauma and vascular surgery. The threshold for diagnosis was variable, as were the numbers of patients that were decompressed. This study would suggest that there is a need for standardisation of diagnostic threshold and protocols regarding decompression in ACS(3).
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