Abstract：
BACKGROUND:The open abdomen (OA) is commonly utilized as a technique during damage control laparotomy (DCL). We propose that a selected group of these OA patients can be extubated prior to abdominal closure to decrease ventilator days and risk of pneumonia. METHODS:A retrospective chart review was performed at a Level I trauma center on all adult trauma patients with an OA following DCL. Patients were stratified into two groups: extubated prior to (PRE) and extubated after (POST) abdominal closure. Successful extubation in the PRE group was measured by the absence of re-intubation. The two groups were compared using the Mann-Whitney U and Fisher's exact tests. Multivariate logistic regression identified independent predictors for successful extubation prior to abdominal closure. RESULTS:Thirty-one patients were in the PRE group, and 59 patients in the POST group. There were no differences between the groups with regard to age, gender, or hours from admission to completion of DCL. The PRE group had a significantly higher incidence of penetrating trauma (77 vs. 53%; p = 0.02), a significantly lower number of days from OA to extubation [0.6 (0.2-1.1) vs. 3.4 (2--8) days; p < 0.001], and a significant decrease in pneumonia (10 vs. 31%; p = 0.04). Two patients in each group required re-intubation [PRE (6%) vs. POST (3%); p = 0.61]. In a multivariate binominal logistic regression, penetrating trauma (p = 0.024), GCS on admission (p < 0.0001), and Injury Severity Score (p = 0.024) were identified as independent predictors for successful extubation. CONCLUSION:Presence of an OA following DCL does not require mechanical ventilation. Extubation of appropriate trauma patients prior to abdominal closure decreases pneumonia and hospital length of stay.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Sujka JA,Safcsak K,Cheatham ML,Ibrahim JAdoi
10.1007/s00268-018-4610-1subject
Has Abstractpub_date
2018-10-01 00:00:00pages
3210-3214issue
10eissn
0364-2313issn
1432-2323pii
10.1007/s00268-018-4610-1journal_volume
42pub_type
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journal_title：World journal of surgery
pub_type： 杂志文章
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：1990-05-01 00:00:00
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journal_title：World journal of surgery
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更新日期：2015-03-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2018-11-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2003-12-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-020-05385-6
更新日期：2020-05-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2019-01-01 00:00:00
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2011-04-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2018-06-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2016-12-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,已发布勘误
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更新日期：2019-05-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2000-01-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2018-01-01 00:00:00
