Study of damage control strategy for non-traumatic diseases: a single-center observational study.
Acute abdomen
Damage control strategy
Non-traumatic diseases
Open abdominal management
Septic shock
Journal
European journal of medical research
ISSN: 2047-783X
Titre abrégé: Eur J Med Res
Pays: England
ID NLM: 9517857
Informations de publication
Date de publication:
01 Oct 2022
01 Oct 2022
Historique:
received:
27
06
2022
accepted:
21
09
2022
entrez:
1
10
2022
pubmed:
2
10
2022
medline:
5
10
2022
Statut:
epublish
Résumé
Damage control strategy (DCS) has been introduced not only for trauma but also for acute abdomen, but its indications and usefulness have not been clarified. We examined clinical characteristics of patients who underwent DCS and compared clinical characteristics and results with and without DCS in patients with septic shock. We targeted a series of endogenous abdominal diseases in Kansai Medical University Hospital from April 2013 to March 2019. Clinical characteristics of 26 patients who underwent DCS were examined. Then, clinical characteristics and results were compared between the DCS group (n = 26) and non-DCS group (n = 31) in 57 patients with septic shock during the same period. All 26 patients who underwent DCS had septic shock, low mean arterial pressure (MAP) before the start of surgery, and required high-dose norepinephrine administration intraoperatively. Their discharge mortality rate was 12%. Among the patients with septic shock, the DCS group had a higher SOFA score (P = 0.008) and MAP was lower preoperatively, but it did not increase even with intraoperative administration of large amounts of fluid replacement and vasoconstrictor. There was no significant difference in 28-day mortality and discharge mortality between the two groups. DCS may be useful in patients with severe septic shock.
Sections du résumé
BACKGROUND
BACKGROUND
Damage control strategy (DCS) has been introduced not only for trauma but also for acute abdomen, but its indications and usefulness have not been clarified. We examined clinical characteristics of patients who underwent DCS and compared clinical characteristics and results with and without DCS in patients with septic shock.
METHODS
METHODS
We targeted a series of endogenous abdominal diseases in Kansai Medical University Hospital from April 2013 to March 2019. Clinical characteristics of 26 patients who underwent DCS were examined. Then, clinical characteristics and results were compared between the DCS group (n = 26) and non-DCS group (n = 31) in 57 patients with septic shock during the same period.
RESULTS
RESULTS
All 26 patients who underwent DCS had septic shock, low mean arterial pressure (MAP) before the start of surgery, and required high-dose norepinephrine administration intraoperatively. Their discharge mortality rate was 12%. Among the patients with septic shock, the DCS group had a higher SOFA score (P = 0.008) and MAP was lower preoperatively, but it did not increase even with intraoperative administration of large amounts of fluid replacement and vasoconstrictor. There was no significant difference in 28-day mortality and discharge mortality between the two groups.
CONCLUSIONS
CONCLUSIONS
DCS may be useful in patients with severe septic shock.
Identifiants
pubmed: 36183102
doi: 10.1186/s40001-022-00823-8
pii: 10.1186/s40001-022-00823-8
pmc: PMC9526978
doi:
Substances chimiques
Vasoconstrictor Agents
0
Norepinephrine
X4W3ENH1CV
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
192Informations de copyright
© 2022. The Author(s).
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