Current opinion in critical care · 2025
ICU imperatives in open abdomen management after trauma or emergency surgery.
СтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Leonard Jennifer Marie, Cecconi Maurizio, Kaplan Lewis J
Аннотация
PURPOSE OF REVIEW: This review is both timely and relevant as the open abdomen approach to manage injury, emergency general surgery (EGS) conditions, as well as secondary intra-abdominal hypertension (IAH) and the abdominal compartment syndrome (ACS) remain prevalent throughout ICUs.
RECENT FINDINGS: IAH is not limited to those with injury or EGS conditions, as it is increasingly recognized following cardiac surgery as well as cardiac transplantation. IAH monitoring techniques benefit from technological advances including noninvasive devices. Time to primary fascial closure (PFC) is a key determinant of patient-centered outcomes, with worse outcomes in those with delayed or failed closure attempts. Visceral edema avoidance or mitigation techniques remain controversial. Nutrition support and its impact on the gastrointestinal microbiome appear to influence infection risk and anastomotic integrity. Team-based approaches to successful as well as failed open abdomen management help optimize outcomes.
SUMMARY: These findings bear broad implications for intensive care medicine clinicians who care for open abdomen patients, as they address resuscitation, intra-abdominal pressure monitoring, and nutrition support all of which influence the likelihood of achieving PFC - a key goal regardless of whether the abdomen was initially left open after injury, EGS, or intestinal ischemia management.
RECENT FINDINGS: IAH is not limited to those with injury or EGS conditions, as it is increasingly recognized following cardiac surgery as well as cardiac transplantation. IAH monitoring techniques benefit from technological advances including noninvasive devices. Time to primary fascial closure (PFC) is a key determinant of patient-centered outcomes, with worse outcomes in those with delayed or failed closure attempts. Visceral edema avoidance or mitigation techniques remain controversial. Nutrition support and its impact on the gastrointestinal microbiome appear to influence infection risk and anastomotic integrity. Team-based approaches to successful as well as failed open abdomen management help optimize outcomes.
SUMMARY: These findings bear broad implications for intensive care medicine clinicians who care for open abdomen patients, as they address resuscitation, intra-abdominal pressure monitoring, and nutrition support all of which influence the likelihood of achieving PFC - a key goal regardless of whether the abdomen was initially left open after injury, EGS, or intestinal ischemia management.