Annals of
Intensive Care volume 15, Article number: 106, Published: 24
July 2025
Abstract
Objectives
To provide a comprehensive overview of current research on
intensive care providers’ awareness, knowledge, and practices regarding
IAP/IAH/ACS, as well as barriers to IAP measurement.
Methods
This scoping review was guided by the framework of Arksey
and Malley. Eight databases were searched to identify research published after
2007, including MEDLINE Complete, EMBASE, Web of Science, Cochrane Library,
CINAHL Complete, ProQuest Health & Medical Complete, CNKI, and WANFANG. Two
researchers reviewed and screened potentially relevant studies based on title
and abstract. Full-text articles were independently assessed for eligibility
based on predefined inclusion criteria.
Results
Nineteen articles were included. Overall, pediatric
intensive care providers demonstrated a lower awareness and knowledge of
IAH/ACS compared to adult intensive care providers, particularly regarding the
consensus definitions of IAH/ACS in critically ill children. IAP measurement
has not been adequately integrated into clinical practice, with 18.0–73.0% of
intensive care providers reporting they have never measured it. The frequency
of IAP measurements and the criteria for determining which patients necessitate
such measurements exhibited significant variability across different hospitals.
The most frequently mentioned barriers to IAP measurement include a lack of
knowledge regarding IAP measurement among adult intensivists, an overreliance
on physical examination among pediatric intensivists, uncertainty in
interpreting IAP data among adult intensive care nurses, and challenges in
identifying populations at high risk of IAH among pediatric intensive care
nurses. Diuretics were mentioned most often in the management of IAH/ACS,
followed by administration of vasopressors and inotropes, decompressive
laparotomy, and judicious administration of fluids and blood products.
37.0–66.3% of adult intensivists would choose a decompressive laparotomy in
cases of ACS, whereas pediatric intensivists were less inclined to opt for the
same approach.
Conclusions
Since the publication of the WSACS consensus in 2007, there
has been an improvement in awareness and knowledge regarding IAP/IAH/ACS among
intensive care providers. Nevertheless, the understanding of the consensus
definitions regarding IAH/ACS remains inadequate, particularly among pediatric
intensive care providers. It is imperative to advocate for the implementation
of WSACS guidelines in hospitals through targeted training programs and to
promote the routine practice of IAP measurement in clinical settings.
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