Advances in Medical Ethics
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Abdominal Compartment Syndrome is Acknowledged by Juvenile Medical Practitioners

Niranjan Chandi^{* *}Correspondence: Niranjan Chandi, Department of Pharmaceutical and Food Analysis, Lumbini Buddhist University, Lumbini Sanskritik, Nepal, Email:

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Introduction

The paucity of reports of Abdominal Compartment Syndrome (ACS) in pediatric literature may be a sign that pediatric Health Care Professionals (HCP) lack awareness and acknowledgment of the condition. Purpose to gauge pediatric HCP's awareness of ACS, understanding of its concept, and familiarity with the methods for measuring Intra-Abdominal Pressure (IAP). Method a written questionnaire distributed at two conferences on pediatric critical care. Results 1107 surveys had a completion rate of 47%. Pediatric intensivists, pediatric nurses, and others were participants. The majority of participants, 77%, were aware of ACS. Only 46.8% accurately defined ACS. Participants varied in their use of the IAP threshold value that was used to define ACS. Only 83 out of 343 participants (about 24%) had ever measured IAP. Conclusion A poll of HCP revealed that 23% were ignorant of ACS. The standards used to categories ACS varied. Targeted education on recognition of ACS and measuring IAP should be promoted among pediatric HCP.

Description

In order to promote research and enhance patient care, the World Society of the Abdominal Compartment Syndrome (WSACS) has defined definitions for Intra-Abdominal Hypertension (IAH) and Abdominal Compartment Syndrome (ACS) as well as standardized methodologies for IAP monitoring. Having a persistent IAP of 20 mmHg or above (with or without an abdominal perfusion pressure of 60 mmHg) and new organ dysfunction or failure is referred to as ACS. IAP 12 mmHg elevations that are sustained or recurrently pathogenic are known as IAH.

Despite having an apparent modest frequency of 0.9% to 12%, ACS has a clinically substantial direct detrimental effect on mortality and organ performance. It is a standalone mortality predictor. Depending on the population being researched and the criteria of ACS being employed, the death rate related to ACS ranges from 50% to 80%. It is linked to a variety of illnesses that are encountered in the intensive care unit. To reduce the morbidity and mortality linked to ACS, it is crucial that pediatric Healthcare Professionals (HCP) know how to identify, treat, and most critically, prevent ACS in individuals at risk. The fact that publications in this area involving children have lagged far behind those involving the adult population reflects a lack of awareness, expertise, or interest on the part of pediatric HCP.

This research was authorized by Loma Linda University's Institutional Review Board. The questionnaire used was initially validated through a pilot study. The correlation between items addressing the same objectives was used to evaluate the validity of the questionnaire. Additionally, factor analysis was employed to evaluate the questionnaire's construct validity. An alpha coefficient of 0.86 and significance were attained by the internal consistency of ACS awareness. On questions addressing related issues, Cronbach's alpha indicated between 89.5% and 100% agreement. The degree of agreement for questions where a minimal level of agreement was anticipated ranged from 9.1% to 16.7%.

The 10 items written questionnaire was distributed at a national conference for pediatric critical care nurses in 2006 and at the world congress of pediatric critical care in 2007 following validation of the questionnaire as an adequate tool intended specifically to assess pediatric HCP' awareness of ACS. The survey was filled out voluntarily as proof of agreement to participate in the study. It was given out at the start of sessions that weren't focused on teaching about IAH, ACS, or related topics and collected at the conclusion of each one. In actuality, neither of these conferences' official programmes included any discussions of IAH or ACS related topics.

The survey questions elicited data about pediatric HCP's awareness of ACS (one question), criteria for recognizing it, current monitoring of IAP, and experience managing ACS (four questions). We also asked about the number of years of ICU experience, the type of practice (tertiary or community hospital), and the location of the clinic. An excel spreadsheet was used to enter and analyse the data collected from the questionnaires.

The categorical variables' descriptive statistics were count and percent. In order to evaluate the factors that influence ACS awareness, IAP measurement, and ACS definition knowledge, multivariable logistic regression was used. To determine the univariate effect of the putative outcome factors, invariable logistic regression was performed. After accounting for all the other variables in the model, the significant variables were then included in a multivariable analysis to be evaluated. SPSS statistical software version 17.0 was used to conduct all statistical analyses (SPSS Institute Inc). The cutoff for statistical significance was P of 05.

Conclusion

Pediatric intensivists had the highest level of awareness of ACS among the pediatrics HCP surveyed, which was the majority of them. Children-specific definitions of ACS are required. For the diagnosis and early detection of ACS among pediatric HCP, further education about the significance of objective monitoring of IAP is required.