Table 3.
Distribution of responses. Table shows the responses given by the pediatric intensive care units surveyed regarding awareness, diagnosis, and treatment of IAH and ACS between 2010 and 2016 (subjective, semi-quantitative assessment). A chi-square test for independent samples was used to statistically represent differences between 2010 and 2016
| Question | Stated question and choices | 2010 Answers % (number) | 2016 Answers % (number) | p-value |
|---|---|---|---|---|
| B.1 | Occurrence and relevance of IAH/ACS in clinical practice | 0.088 | ||
| • Never | 56 (83/149) | 45 (69/155) | ||
| • Seldom | 38 (57/149) | 42 (65/155) | ||
| • Regularly | 5 (8/149) | 12 (18/155) | ||
| • Often | 1 (1/149) | 2 (3/155) | ||
| B.2 | Increase in diagnosis of IAH and ACS since 2010 | 13 (21/156) | ||
| B.3 | Frequency of IAH diagnosed at ICU’s responding (during the entire year before) | 0.366 | ||
| • 0 times IAH | 65 (96/148) | 63 (94/150) | 0.130 | |
| • 1 to 10 times IAH | 30 (44/148) | 35 (52/150) | ||
| • > 10 times IAH | 5 (8/148) | 3 (4/150) | ||
| Frequency of ACS diagnosed at ICU’s responding (during the entire year before) | ||||
| • 0 times ACS | 75 (112/149) | 65 (95/147) | ||
| • 1 to 5 times ACS | 23 (35/149) | 33 (48/147) | ||
| • > 5 times ACS | 1 (2/149) | 3 (4/147) | ||
| B.4 | Awareness and use of current WSACS definitions (tested by multiple choice) | |||
| • IAH definition correctly chosen (increased IAP) | 4 (6/147) | 6 (6/97) | 0.457 | |
| • ACS definition correctly chosen (IAH + new organ dysfunction) | 18 (27/147) | 58 (58/99) | < 0.001 | |
| Clinical symptoms stated to be associated with increased IAP in children (Fig. 3) | ||||
| Respiratory-organ-systems: | ||||
| Respiratory insufficiency | 13 (25/195) | 9 (25/283) | ||
| Radiologic findings with diaphragmatic protrusion | 8 (16/195) | 13 (38/283) | ||
| Cardiovascular-organ-systems: | ||||
| Perfusion deficit | 8 (16/195) | 6 (16/283) | ||
| Cardio-circulatory insufficiency | 4 (8/195) | 7 (21/283) | ||
| Impaired venous reflux, increased CVP | 4 (7/195) | 7 (19/283) | ||
| Lactic acidosis | 1 (1/195) | 1 (3/283) | ||
| Shock and capillary leak syndrome | 1 (1/195) | 1 (2/283) | ||
| Renal-organ-system: | ||||
| Oliguria to anuria | 21 (40/195) | 21 (60/283) | ||
| Gastrointestinal-organ-system: | ||||
| Clinical abdominal symptoms, pain | 29 (57/195) | 29 (83/283) | ||
| Gastrointestinal motility dysfunction | 5 (10/195) | 4 (10/283) | ||
| Hepatic-organ-system: | ||||
| Liver insufficiency and ascites | 2 (4/195) | 1 (4/283) | ||
| Others: | ||||
| No further differentiated organ dysfunction | 5 (9/195) | 1 (2/283) | ||
| Anamnesis | 1 (1/195) | n/a | ||
| B.5 | Share of respondents who measured IAP | |||
| • Yes | 20 (30/151) | 43 (65/152) | < 0,001 | |
| ○ Seldom | 29 (44/152) | |||
| ○ Regularly | 20 (30/151) | 11 (17/152) | ||
| ○ Often | 3 (4/152) | |||
| • No | 80 (121/151) | 57 (87/152) | ||
| B.6 | Share of respondents having performed at least one decompressive laparotomy | 19 (29/149) | 36 (55/153) | < 0,001 |
| Stated survival rate of ACS patients | 0,84 | |||
| • Surgically treated children | 83 ± 32 (n = 23) | 85 ± 17 (n = 48) | ||
| • Non- surgically treated children | 65 ± 44 (n = 10) | 40 ± 34 (n = 33) | ||
| Share of respondents who needed to leave the abdomen open postoperatively (only 2016) | 95 (39/41) | |||
Abbrev.: ACS Abdominal compartment syndrome, CVP Central venous pressure, IAH Intra-abdominal hypertension, IAP Intra-abdominal pressure, ICU Intensive care unit
The p values are taken from the analysis using the chi square test