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. 2015 Nov 6:10:54.
doi: 10.1186/s13017-015-0047-0. eCollection 2015.

The impact of early surgical intervention in free intestinal perforation: a time-to-intervention pilot study

Affiliations

"V体育2025版" The impact of early surgical intervention in free intestinal perforation: a time-to-intervention pilot study

Andreas Hecker et al. World J Emerg Surg. .

Abstract (VSports)

Purposes: An abdominal inflammatory focus is the second most often source of sepsis with a high risk of death in surgical intensive care units. By establishing evidence-based bundled strategies the surviving sepsis campaign provided an optimized rapid and continuous treatment of these emergency patients. Hereby the hospital mortality decreased from 35 to 30 %. Sepsis treatment is based on three major therapeutic elements: surgical treatment (source control), antiinfective treatment, and supportive care. The international guidelines of the surviving sepsis campaign were updated recently and recommend rapid diagnosis of the infection and source control within the first 12 h after the diagnosis (grade 1c). Interestingly this recommendation is mainly based on studies on soft tissue infections. VSports手机版.

Methods: In this retrospective analysis 76 septic patients with an intraabdominal inflammatory focus were included. All patients underwent surgery at different time-points after diagnosis. V体育安卓版.

Results: With 80 % patients of the early intervention group had an improved overall survival (vs. 73 % in the late intervention group). V体育ios版.

Conclusions: Literature on the time dependency of early source control is rare and in part contradicting VSports最新版本. Results of this pilot study reveal that immediate surgical intervention might be of advantage for septic emergency patients. Further multi-center approaches will be necessary to evaluate, whether the TTI has any impact on the outcome of septic patients with intestinal perforation. .

Keywords: Free intestinal perforation; Sepsis; Time-to-intervention V体育平台登录. .

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Figures

Fig. 1
Fig. 1
Study protocoll of this retrospective analysis of patients with an intestinal perforation at our university hospital: Of 179 patients with the diagnosis of a perforation in the GI-tract 79 met the inclusion criteria of this pilot study. These patients were attributed to the three study arms according to their time-to-intervention
Fig. 2
Fig. 2
The different reasons for the perforation reflects the typical pattern of a European university hospital
Fig. 3
Fig. 3
All study groups were equal concerning the duration of surgical source control. The time-to-intervention had no significant impact on the time of mechanical ventilation or the amount of catecholamins adiministered after surgery. o and * represent single spike values
Fig. 4
Fig. 4
The time-courses of creatinine (a), urea (b), C-reactive protein (CRP) (c) and serum lactate (d) before surgical source control and in the postoperative phase. o and * represent single spike values

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