Measurement and knowledge of intra-abdominal pressure in Italian Intensive Care Units

Background. With this survey, we aimed at investigating the knowledge, recognition and management of intra-abdominal pressure (IAP) and abdominal hypertension (IAH) in Italian Intensive Care Units. Methods. A questionnaire was sent to the "Intensive Care Unit lead physician" of 114 italian hospitals. Results. One hundred fourteen questionnaires were sent, and 77 (67.5%) of them were returned completed. IAP was measured in 51 Units (66.3%). The most frequent reasons for not measuring IAP were the lack of a specific IAP monitoring kit (34.6%) and not knowing how to make the measurement (23.0%). Urinary bladder pressure was the only method used to measure IAP, the most frequent timing for IAP measurements was once every 4 h. An IAP value of 15 mmHg was considered to be the threshold for IAH in 33.4% of the cases, whereas in 31.4% of cases it was 20 mmHg. The presence of risk factors for IAH (64.7%) and a previous urgent surgery (21.5 %) were indicators of IAP monitoring. Diagnosis of IAH prompted a surgical consultation and evaluation, also in view of a possible abdominal decompression in 64.7 % of cases. More than half (54.9%, n=28) of the 51 ICUs where LAY was measured reported to be unaware of the World Society of the Abdominal Compartment Syndrome. Conclusion. Italian intensive care unit physicians show a certain interest towards IAP monitoring and its implications in the management of critically ill patients. However, IAP, IAH and abdominal compartment syndrome still require greater basic understanding.