Intra-Abdominal Hypertension Clinical Trial
Official title:
Surveillance, Prevention and Treatment of Intra-abdominal Hypertension and Abdominal Compartment Syndrome: A Single Center Prospective Cohort Study
This study evaluates the efficacy of intensive surveillance, prevention and treatment of intra-abdominal hypertension in ICU patients. In the first two months patients will be screened and undergo usual care. In the following 10-months patients will have more intensive screening and active measures towards prevention and treatment according to best practices.
Elevated intra-abdominal pressures or intra-abdominal hypertension (IAH) has been shown to be
common in all intensive care unit (ICU) patients (upwards of 50%) and has been suggested as
the missing link in multi-organ dysfunction, and subsequently ICU mortality. Despite
guidelines advocating prevention and surveillance of IAH, adherence remains low in most ICUs
across North America and Europe.
The creation of the World Society of the Abdominal Compartment Syndrome (WSACS) in 2004
improved the recognition of IAH/ACS by intensivists. The first consensus guidelines from the
WSACS were released in 2006, followed by a 2013 update. Additionally, clinical practice
guidelines and recommendations for research were released in 2007 and 2009 respectively,
which attempted to standardize research methods and reporting. Unfortunately, even in the
2013 guidelines only WEAK recommendations (by GRADE methodology) could be made regarding the
efficacy of surveillance and treatment of IAH/ACS, citing a lack of high quality
interventional trials.
The investigator's study aims to assess the feasibility of a larger multi-center
interventional trial to investigate the efficacy of aggressive screening, prevention and
treatment of IAH in ICU patients.
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