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) | |||