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Harvin, John A.; Mims, Mark M; Duchesne, Juan; Cox, Charles S.; Wade, Charles E.; Holcomb, John B.; Cotton, Bryan A.

doi:10.1097/ta.0b013e31827e2a96

Cited by 55 publications

(26 citation statements)

References 28 publications

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“…As a counterpart, whenever possible, frequent, small-volume fluid boluses should be preferred. Hypertonic crystalloid and colloid-based resuscitation seem to decrease the risk of iatrogenic, induce resuscitation, and increase IAP [ 55 ]. Daily patient weights may help in evaluating fluid retention.…”

Section: Methodsmentioning

confidence: 99%

The open abdomen in trauma and non-trauma patients: WSES guidelines

et al. 2018

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Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a “planned second-look” laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.

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Section: Methodsmentioning

confidence: 99%

The open abdomen in trauma and non-trauma patients: WSES guidelines

et al. 2018

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“…The authors hypothesized that the reason for this difference was due to the shift of fluid to the intravascular space with hypertonic saline and due to its potential ability to attenuate the inflammatory response. 91 …”

Section: Fluid Status and Intra-abdominal Physiologymentioning

confidence: 99%

Open abdomen critical care management principles: resuscitation, fluid balance, nutrition, and ventilator management

Chabot

Nirula

2017

Trauma Surg Acute Care Open

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The term “open abdomen” refers to a surgically created defect in the abdominal wall that exposes abdominal viscera. Leaving an abdominal cavity temporarily open has been well described for several indications, including damage control surgery and abdominal compartment syndrome. Although beneficial in certain patients, the act of keeping an abdominal cavity open has physiologic repercussions that must be recognized and managed during postoperative care. This review article describes these issues and provides guidelines for the critical care physician managing a patient with an open abdomen.

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“…Improved fluid management may decrease the incidence of ACS and promote early fascial closure [28,65,66]. There is also some evidence that the use of hypertonic fluids in the postoperative period may decrease time to primary closure and improve the primary closure rate [67]. Patients should be monitored for development of ACS and if exhibiting symptoms, the TAC should be removed and replaced with a looser device immediately [2].…”

Section: Reviewmentioning

confidence: 99%

Abdominal damage control surgery and reconstruction: world society of emergency surgery position paper

et al. 2013

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Damage control laparotomy was first described by Dr. Harlan Stone in 1983 when he suggested that patients with severe trauma should have their primary procedures abbreviated when coagulopathy was encountered. He recommended temporizing patients with abdominal packing and temporary closure to allow restoration of normal physiology prior to returning to the operating room for definitive repair. The term damage control in the trauma setting was coined by Rotondo et al., in 1993. Studies in subsequent years have validated this technique by demonstrating decreased mortality and immediate post-operative complications. The indications for damage control laparotomy have evolved to encompass abdominal compartment syndrome, abdominal sepsis, vascular and acute care surgery cases. The perioperative critical care provided to these patients, including sedation, paralysis, nutrition, and fluid management strategies may improve closure rates and recovery. In the rare cases of inability to primarily close the abdomen, there are a number of reconstructive strategies that may be used in the acute and chronic phases of abdominal closure.

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Abstract: Diagnostic study, level III.

Cited by 55 publications

References 28 publications

The open abdomen in trauma and non-trauma patients: WSES guidelines

The open abdomen in trauma and non-trauma patients: WSES guidelines

Open abdomen critical care management principles: resuscitation, fluid balance, nutrition, and ventilator management

Abdominal damage control surgery and reconstruction: world society of emergency surgery position paper

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