TITLE

Open Abdomen Management of Intra-abdominal Sepsis

AUTHOR(S)
Adkins, Amy L.; Robbins, James; Villalba, Mario; Bendick, Phillip; Shanley, Charles J.
PUB. DATE
February 2004
SOURCE
American Surgeon;Feb2004, Vol. 70 Issue 2, p137
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Despite surgical advances, antimicrobial therapy, and intensive care, the morbidity and mortality of intro-abdominal sepsis remains high. The primary purpose of this study was to determine whether open abdomen management of intro-abdominal sepsis reduces intensive care unit (ICU) and hospital mortality. The records of 81 consecutive patients with open abdomen management for intro-abdominal sepsis admitted to the surgical ICU from January 1998 to April 2002 were retrospectively reviewed. Outcomes were compared to a historical control group with primary abdominal closure, also admitted to the surgical ICU with intro-abdominal sepsis and matched for sex, age, source of sepsis, and APACHE III score. ICU mortality for the open abdomen group was 25 per cent versus 17 per cent for the control group. Hospital mortality was 33 per cent and 25 per cent for the open abdomen patients and historical controls, respectively. Both ICU and hospital length of stay were significantly longer for the open abdomen group. An overall fistula rate of 14.8 per cent was demonstrated in the open abdomen patients. A significant difference in overall ICU and hospital mortality was not demonstrated between patients treated with open abdomen management and historical controls. A prospective randomized study accounting for extent of sepsis may define a role for open abdomen management in selected subgroups of patients.
ACCESSION #
12618928

 

Related Articles

  • Quality of blood culture testing - a survey in intensive care units and microbiological laboratories across four European countries. Schmitz, Roland P.; Keller, Peter M.; Baier, Michael; Hagel, Stefan; Pletz, Mathias W.; Brunkhorst, Frank M. // Critical Care;2013, Vol. 17 Issue 5, p1 

    Introduction Blood culture (BC) testing before initiation of antimicrobial therapy is recommended as a standard of care in international sepsis guidelines and has been shown to reduce intensive care unit (ICU)-stay, antibiotic use, and costs in hospitalized patients. Whereas microbiological...

  • Neutropenic cancer patients with severe sepsis: need for antibiotics in the first hour. Mokart, Djamel; Saillard, Colombe; Sannini, Antoine; Chow-Chine, Laurent; Brun, Jean-Paul; Faucher, Marion; Blache, Jean-Louis; Blaise, Didier; Leone, Marc // Intensive Care Medicine;Aug2014, Vol. 40 Issue 8, p1173 

    The article focuses on a study which aim to identify intensive care unit (ICU) admission predictive factors associated with ICU mortality. Topics discussed include the need for aprompt initiation of an appropriate antimicrobial treatment in neutropenic cancer patients admitted to ICU for severe...

  • HOSPITAL-ACQUIRED PNEUMONIA IN ICU PATIENTS. Uvizl, Radovan; Hanulik, Vojtěch; Husickova, Vendula; Sedlakova, Miroslava Htoutou; Adamus, Milan; Kolar, Milan // Biomedical Papers of the Medical Faculty of Palacky University i;Dec2011, Vol. 155 Issue 4, p373 

    Background. This prospective study aimed at assessing the effect of initial antibiotic therapy on the mortality of patients with hospital-acquired pneumonia (HAP) by analyzing bacterial pathogens and their resistance to antimicrobial agents. Methods. Included were patients hospitalized in the...

  • De-escalation versus continuation of empirical antimicrobial treatment in severe sepsis: a multicenter non-blinded randomized noninferiority trial. Leone, Marc; Bechis, Carole; Baumstarck, Karine; Lefrant, Jean-Yves; Albanèse, Jacques; Jaber, Samir; Lepape, Alain; Constantin, Jean-Michel; Papazian, Laurent; Bruder, Nicolas; Allaouchiche, Bernard; Bézulier, Karine; Antonini, François; Textoris, Julien; Martin, Claude // Intensive Care Medicine;Oct2014, Vol. 40 Issue 10, p1399 

    Background: In patients with severe sepsis, no randomized clinical trial has tested the concept of de-escalation of empirical antimicrobial therapy. This study aimed to compare the de-escalation strategy with the continuation of an appropriate empirical treatment in those patients. Methods: This...

  • Antibiotic prophylaxis in severe acute pancreatitis- what are the facts? Slavin, J.; Neoptolemos, J. P. // Langenbeck's Archives of Surgery;Apr2001, Vol. 386 Issue 2, p155 

    After acute pancreatitis, sepsis secondary to infected pancreatic necrosis is the main cause of late stage death. Routine prophylactic antibiotic use following a severe attack of pancreatitis has been proposed but remains contentious. Three recent randomised controlled studies compared routine...

  • Epidemiology of sepsis in Germany: results from a national prospective multicenter study. Engel, Christoph; Brunkhorst, Frank M.; Bone, Hans-Georg; Brunkhorst, Reinhard; Gerlach, Herwig; Grond, Stefan; Gruendling, Matthias; Huhle, Guenter; Jaschinski, Ulrich; John, Stefan; Mayer, Konstantin; Oppert, Michael; Olthoff, Derk; Quintel, Michael; Ragaller, Max; Rossaint, Rolf; Stuber, Frank; Weiler, Norbert; Welte, Tobias; Bogatsch, Holger // Intensive Care Medicine;Apr2007, Vol. 33 Issue 4, p606 

    Objective: To determine the prevalence and mortality of ICU patients with severe sepsis in Germany, with consideration of hospital size.Design: Prospective, observational, cross-sectional 1-day point-prevalence study.Setting: 454 ICUs from a representative...

  • Sepsis Syndrome in Croatian Intensive Care Units: Piloting a National Comparative Clinical Database. Gašparović, Vladimir; Gornik, Ivan; Ivanović, Dragutin // Croatian Medical Journal;2006, Vol. 47 Issue 3, p404 

    Aim To assess the incidence of sepsis in selected intensive care units (ICUs) in Croatia, isolates from blood cultures, and sepsis outcomes, and to compare the results with those from other European countries. Methods In the pilot phase of the national comparative clinical database project, we...

  • Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis study. Karlsson, Sari; Varpula, Marjut; Ruokonen, Esko; Pettilä, Ville; Parviainen, Ilkka; Ala-Kokko, Tero; Kolho, Elina; Rintala, Esa; Pettilä, Ville; Ala-Kokko, Tero I; Rintala, Esa M // Intensive Care Medicine;Mar2007, Vol. 33 Issue 3, p435 

    Objective: To determine the incidence and outcome of severe sepsis in the adult Finnish population and to evaluate how treatment guidelines in severe sepsis are applied in clinical practice.Study Design: A prospective study in 24 closed multidisciplinary ICUs in 21...

  • Declining Case Fatality Rates for Severe Sepsis Good Data Bring Good News With Ambiguous Implications. Iwashyna, Theodore J.; Angus, Derek C. // JAMA: Journal of the American Medical Association;4/2/2014, Vol. 311 Issue 13, p1295 

    The author discusses the study conducted by Kaukonen et al. on intensive care units (ICU) incidence of critically-ill severe sepsis and septic shock in Australia and New Zealand. Tackled are the mortality rates within hospitals from both countries. The significance of longer-term morbidity...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics