Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome.
Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome.
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DOI：
10.1007/s00134-013-2906-z
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发表时间：
2013-07
影响因子：
38.9
通讯作者：
Olvera, Claudia
中科院分区：
文献类型：
--
作者：
Kirkpatrick, Andrew W.;Roberts, Derek J.;De Waele, Jan;Jaeschke, Roman;Malbrain, Manu L. N. G.;De Keulenaer, Bart;Duchesne, Juan;Bjorck, Martin;Leppaniemi, Ari;Ejike, Janeth C.;Sugrue, Michael;Cheatham, Michael;Ivatury, Rao;Ball, Chad G.;Blaser, Annika Reintam;Regli, Adrian;Balogh, Zsolt J.;D'Amours, Scott;Debergh, Dieter;Kaplan, Mark;Kimball, Edward;Olvera, Claudia
关键词：
更新世界腹部comfort综合征协会（WSACS）关于腹内高压（IAH）和腹腔室隔综合征（ACS）的共识定义和管理声明。我们进行了系统或结构化的审查，以确定有关IAH或ACS的相关研究。然后分别使用修改后的德尔菲法和建议、评估、开发和评价分级（GRADE）指南得出更新的共识定义和管理声明。证据质量从高（A）到极低（D）分级，管理声明从强烈建议（理想效果明显超过潜在的不良效果）到较弱的建议（干预的潜在风险和益处不太清楚）。除了回顾2006年提出的共识定义外，WSACS还定义了开腹、腹部肌肉组织偏侧化、多室综合征和腹部顺应性，并提出了开腹分类系统。建议包括腹内压（IAP）测量，避免持续IAH，协议化的IAP监测和管理，显性ACS的减压剖腹术，负压伤口治疗和努力在开腹患者中实现相同的住院时间筋膜闭合。建议包括使用药物治疗和经皮导管引流治疗IAH/ACS，考虑体位与IAP之间的相关性，尝试避免初始患者复苏后的正液体平衡，使用提高的血浆与红细胞比率和预防性开腹策略，以及避免在腹部开放性伤口患者中常规使用早期生物补片。没有关于监测腹部灌注压或使用利尿剂、肾脏替代治疗、白蛋白或急性组分-部分分离的建议。尽管IAH和ACS很常见，并且经常与不良结局相关，但可用于指导建议制定的证据总体质量普遍较低。IAH和ACS患者迫切需要设计适当的干预试验。本文的在线版本（doi：10.1007/s 00134 -013-2906-z）包含补充材料，可供授权用户使用。
To update the World Society of the Abdominal Compartment Syndrome (WSACS) consensus definitions and management statements relating to intra-abdominal hypertension (IAH) and the abdominal compartment syndrome (ACS). We conducted systematic or structured reviews to identify relevant studies relating to IAH or ACS. Updated consensus definitions and management statements were then derived using a modified Delphi method and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guidelines, respectively. Quality of evidence was graded from high (A) to very low (D) and management statements from strong RECOMMENDATIONS (desirable effects clearly outweigh potential undesirable ones) to weaker SUGGESTIONS (potential risks and benefits of the intervention are less clear). In addition to reviewing the consensus definitions proposed in 2006, the WSACS defined the open abdomen, lateralization of the abdominal musculature, polycompartment syndrome, and abdominal compliance, and proposed an open abdomen classification system. RECOMMENDATIONS included intra-abdominal pressure (IAP) measurement, avoidance of sustained IAH, protocolized IAP monitoring and management, decompressive laparotomy for overt ACS, and negative pressure wound therapy and efforts to achieve same-hospital-stay fascial closure among patients with an open abdomen. SUGGESTIONS included use of medical therapies and percutaneous catheter drainage for treatment of IAH/ACS, considering the association between body position and IAP, attempts to avoid a positive fluid balance after initial patient resuscitation, use of enhanced ratios of plasma to red blood cells and prophylactic open abdominal strategies, and avoidance of routine early biologic mesh use among patients with open abdominal wounds. NO RECOMMENDATIONS were possible regarding monitoring of abdominal perfusion pressure or the use of diuretics, renal replacement therapies, albumin, or acute component-parts separation. Although IAH and ACS are common and frequently associated with poor outcomes, the overall quality of evidence available to guide development of RECOMMENDATIONS was generally low. Appropriately designed intervention trials are urgently needed for patients with IAH and ACS. The online version of this article (doi:10.1007/s00134-013-2906-z) contains supplementary material, which is available to authorized users.
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影响因子：
38.9
作者：
Antonelli, Massimo;Bonten, Marc;Cecconi, Maurizio;Chastre, Jean;Citerio, Giuseppe;Conti, Giorgio;Curtis, J. Randall;Hedenstierna, Goran;Joannidis, Michael;Macrae, Duncan;Maggiore, Salvatore M.;Mancebo, Jordi;Mebazaa, Alexandre;Preiser, Jean-Charles;Rocco, Patricia;Timsit, Jean-Francois;Wernerman, Jan;Zhang, Haibo
通讯作者：
Zhang, Haibo
影响因子：
2.6
作者：
Bjorck, Martin;Bruhin, Andreas;Windsor, Alastair
通讯作者：
Windsor, Alastair
重症患者的流体管理：血管外肺水，腹部高血压，毛细血管渗漏和液体平衡的作用。
影响因子：
8.1
作者：
Cordemans C;De Laet I;Van Regenmortel N;Schoonheydt K;Dits H;Huber W;Malbrain ML
通讯作者：
Malbrain ML
影响因子：
8.1
作者：
Cordemans C;De Laet I;Van Regenmortel N;Schoonheydt K;Dits H;Martin G;Huber W;Malbrain ML
通讯作者：
Malbrain ML
影响因子：
38.9
作者：
Dalfino, Lidia;Tullo, Livio;Brienza, Nicola
通讯作者：
Brienza, Nicola