Measurement of intra-abdominal pressure in intensive care units in the United Kingdom: a national postal questionnaire study

Background. To explore the attitudes of intensivists in theUK to intra-abdominal pressure (IAP) measurement and abdominalcompartment syndrome (ACS) and to determine current practice. Methods. A postal questionnaire study addressed to the leadclinician in the intensive care unit was sent to hospitals inthe UK with a general surgical service. Results. Completed questionnaires were received from 137 ofthe 207 hospitals surveyed (66.2% response rate). Only 1.5%of the respondents (n=2) had no prior knowledge of intra-abdominalhypertension and ACS. IAP had been measured on some occasionby 75.9% (n=104) of the respondents, always by the intravesicalroute. Among those intensive care units that measured IAP, in93.2% (n=97) it was only measured when there was a suspicionof the development of ACS; 3.8% of units (n=4) measured IAPon all patients who had undergone an emergency laparotomy, and2.9% (n=3) measured IAP only in those who had undergone emergencylaparotomy associated with massive fluid resuscitation. Therewas major disparity in the frequency of IAP measurement andwhen to recommend abdominal decompression. Conclusions. Despite widespread awareness of IAH and the ACS,many intensive care units never measure the IAP. When it ismeasured, the intravesical route is used exclusively. No consensusexists on optimal timing of measurement or when decompressivelaparotomy should be performed.