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2016-03-05 发布于广东
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intra-abdominal hypertension and the abdominal compartment.ppt

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intra-abdominal hypertension and the abdominal compartment

Consensus Management Statements - Recommendation 4) Efforts and/or protocols should be utilized to avoid sustained IAH in critically ill patients GRADE 1C Consensus Management Statements - Recommendation 5) We recommend decompressive laparotomy to decrease IAP in cases of overt ACS compared to strategies that do not use decompressive laparotomy in critically ill adults with ACS [GRADE 1D] Consensus Management Statements - Recommendation 6) We recommend that among ICU patients with open abdominal wounds, conscious and/or protocolized efforts be made to obtain an early or at least same hospital stay closure [GRADE 1D] Consensus Management Statements - Recommendation 7) We recommend that among critically ill/injured patients with open abdominal wounds, strategies utilizing negative pressure wound therapy should be used versus not [GRADE 1C] Suggestions Updated consensus definitions and management statements were then derived using a modified Delphi method and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. 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). Consensus Management Statements - Suggestions 1) We suggest that critically ill or injured patients receive optimal pain and anxiety relief [GRADE 2D] Consensus Management Statements - Suggestions 2) We suggest brief trials of neuromuscular blockade as temporizing measure in the treatment of IAH [GRADE 2D] Consensus Management Statements - Suggestions 3) We suggest that the potential contribution of body position to elevated IAP be considered among patients with, or at risk of, IAH or ACS [GRADE 2D] Consensus Management Statements - Suggestions 4) We suggest using a protocol to try and avoid a positive cumulative fluid balance in the critically ill o