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Clinical characteristics of patients with open abdomen at ICU. A retrospective analysis

Authors

  • María Dolores Navarro-Chagoya <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Servicio de Cirug&iacute;a General. Ciudad de M&eacute;xico</p>
  • Brigitte del Carmen Tejeda-Huezo <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Unidad de Cuidados Intensivos.&nbsp;Ciudad de M&eacute;xico</p>
  • Saira Sanjuana Gómez-Flores <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Unidad de Cuidados Intensivos.&nbsp;Ciudad de M&eacute;xico</p>
  • Luis Alejandro Sánchez-Hurtado <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Unidad de Cuidados Intensivos.&nbsp;Ciudad de M&eacute;xico</p> http://orcid.org/0000-0001-5662-7679

DOI:

https://doi.org/10.24875/RMIMSS.M20000007

Keywords:

Abdomen, Sepsis, Critical Care, Fistulas, Mortality

Abstract

Background: The open abdomen is a surgical management strategy in patients with increased intra-abdominal pressure or when the abdominal wall cannot be closed.

Objective: The aim of this study is to describe the characteristics and clinical outcome of a group of surgical patients with open abdomen who have been admitted to an ICU.

Material and mehotds: Retrospective study in an ICU of a public hospital of reference with subjects admitted with open abdomen. The clinical and demographic characteristics were recorded upon admission to the ICU and were associated with the risk of death in the ICU.

Results: We included 30 patients, with mean of age 51.97 ± 17.77 years. The main reason for admission to the ICU was abdominal sepsis. The severity of the disease by APACHE II was median of 14 points and a SOFA with median of 4.5 points. The lethality in ICU was 46.7%.

Conclusion: The mortality of patients with open abdomen in ICU is high. Surviving subjects have higher number of surgical reoperations and a greater risk of whole cutaneous fistulas.

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Author Biographies

  • María Dolores Navarro-Chagoya, <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Servicio de Cirug&iacute;a General. Ciudad de M&eacute;xico</p>

    Médica especialista en Cirugía general

    Médica especialista en Cirugía de Colon y recto.

  • Brigitte del Carmen Tejeda-Huezo, <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Unidad de Cuidados Intensivos.&nbsp;Ciudad de M&eacute;xico</p>

    Médica especialista Unidad de Cuidados Intensivos Hospital de Especialidades "Antonio Fraga Mouret" Centro Medico Nacional La Raza IMSS

  • Saira Sanjuana Gómez-Flores, <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Unidad de Cuidados Intensivos.&nbsp;Ciudad de M&eacute;xico</p>

    Médica especialista en Medicina Critica, Unidad de Cuidados Intensivos Hospital de Especialidades "Antonio Fraga Mouret" Centro Medico Nacional La Raza IMSS

  • Luis Alejandro Sánchez-Hurtado, <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Unidad de Cuidados Intensivos.&nbsp;Ciudad de M&eacute;xico</p>

    Medico especialista en Medicina Interna y Medicina del Enfermo en Estado Crítico

    Maestro en ciencias por la UNAM

    Evaluación Curricular insititucional IMSS julio 2017 investigador asociado A.

References

Demetriades D, Salim A. Management of the open abdomen. Surg Clin N Am. 2014;94(1):131-53. doi:10.1016/j.suc.2013.10.010

 

De Waele J, Kaplan M, Sugrue M, Sibaja P, Björck M. How to deal with an open abdomen?Anaesthesiol Intensive Ther. 2015;47(4):372-8. doi:10.1016/j.suc.2013.10.010

 

Demetriades D. Total management of the open abdomen. Int J Wound. 2012;9(Suppl 1):s17-s24. doi:10.1111/j.1742-481X.2012.01018.x

 

Burlew C. The open abdomen:practical implications for the practicing surgeon. Am J Surg. 2012;204(6):826-35. doi:doi.org/10.1016/j.amjsurg.2012.04.013

 

Chabot E, Nirula R. Open abdomen critical care management principles:resuscitation, fluid balance, nutrition and ventilator management. Trauma Surg Acute Open. 2017;2(1):e000063. doi:10.1136/tsaco-2016-000063

 

Coccolini F, Biffl W, Catena F, Ceresoli M, Chiara O, Cimbanassi S, et al. The open abdomen:indications, management and definitive closure. World J Emerg Surg. 2015;10:32. doi:10.1186/s13017-015-0026-5

 

Smith B, Adams R, Doraiswamy V, Nagaraja V, Seamon M, Wisler J, et al. Review of abdominal damage control and open abdomens:focus on gastrointestinal complications. J Gastrointest Liver Dis. 2010;19(4):425-35.

 

Ordoñez C, Puyana JC. Management of peritonitis in the critically ill patient. Surg Clin N Am. 2006;86(6):1323-49.

 

Kaplan M, Banwell P, Orgill D, Ivatury R, Demetriades D, Moore F, et al. Guidelines for the management of the open abdomen. Wounds. 2005;17:1-24.

 

Chen Y, Ye J, Song W, Chen J, Yuan Y, Ren J. Comparison of outcomes between early fascial closure and delayed abdominal closure in patients with open abdomen:a systematic review and meta-analysis. Gastroenterol Res Pract. 2014;2014:784056. doi:10.1155/2014/784056

 

Coccolini F, Montorio G, Ceresoli M, Catena F, Ivatury F, Sugrue M, et al. IROA:International Register of Open Abdomen. Preliminary results. World J Emerg Surg. 2017;12:10. doi:10.1186/s13017-017-0123-8

 

Spanu P, Zanforlin G, Noto A, Pezzi A, Marzorati S. Intensive care of patients requiring open abdomen treatment:a case series analysis. Minerva Anestesiol. 2013;79(4):349-59.

 

Van Rulen O, Mahler C, Boer K, Reuland E, Gooszen H, Opmeer B, et al. Comparison of on-demand vs planned relaparotomy strategy in patients with severe peritonitis. JAMA. 2007;298(8):865-73.

 

Hua Y, Li Y. Open abdomen in trauma patients:a doble-edged sword. Military Med Res. 2016;3:10. doi:10.1186/s40779-016-0079-0

 

Maksoud W, Mostafa K, Abdel-Latif M, Hammadi H. Outcome of open abdomen procedure with Bogota bag for temporary abdominal closure:our experience in Alexandria University Hospital. Egyptian J Surgery. 2019;38:807-13.

 

Coccolini F, Montori G, Ceresoli M, Catena F, Moore E, Ivatury R, et al. The role of open abdomen in non-trauma patient:WSES Concensus paper. World J Emerg Surg. 2017;12:39. doi:10.1186/s13017-017-0146-1

 

Gameiro J, Fonseca J, Neves M, Jorge S, Lopes J. Acute kidney injury in major abdominal surgery:incidence, risk factors, pathogenesis and outcomes. Ann Intensive Care. 2018:22:1-10. doi:10.1186/s13613-018-0369-7

Published

2020-04-13

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