Vacuum-assisted closure device enhances recovery of critically ill patients following emergency surgical procedures

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Vacuum-assisted closure device enhances recovery of critically ill patients following emergency surgical procedures

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dc.contributor.author Batacchi, Stefano
dc.contributor.author Matano, Stefania
dc.contributor.author Nella, Alessandra
dc.contributor.author Zagli, Giovanni
dc.contributor.author Bonizzoli, Manuela
dc.contributor.author Pasquini, Andrea
dc.contributor.author Anichini, Valentina
dc.contributor.author Tucci, Valentina
dc.contributor.author Manca, Giuseppe
dc.contributor.author Valeri, Andrea
dc.contributor.author Peris, Adriano
dc.contributor.author Ban, Kevin M.
dc.date.accessioned 2011-04-28T06:34:48Z
dc.date.issued 2009
dc.identifier.citation Batacchi, Stefano, Stefania Matano, Alessandra Nella, Giovanni Zagli, Manuela Bonizzoli, Andrea Pasquini, Valentina Anichini, et al. 2009. Vacuum-assisted closure device enhances recovery of critically ill patients following emergency surgical procedures. Critical Care 13(6): R194. en_US
dc.identifier.issn 1364-8535 en_US
dc.identifier.uri http://nrs.harvard.edu/urn-3:HUL.InstRepos:4878942
dc.description.abstract Introduction: Critically ill surgical patients frequently develop intra-abdominal hypertension (IAH) leading to abdominal compartment syndrome (ACS) with subsequent high mortality. We compared two temporary abdominal closure systems (Bogota bag and vacuum-assisted closure (VAC) device) in intra-abdominal pressure (IAP) control. Methods: This prospective study with a historical control included 66 patients admitted to a medical and surgical intensive care unit (ICU) of a tertiary care referral center (Careggi Hospital, Florence, Italy) from January 2006 to April 2009. The control group included patients consecutively treated with the Bogota bag (Jan 2006-Oct 2007), whereas the prospective group was comprised of patients treated with a VAC. All patients underwent abdominal decompressive surgery. Groups were compared based upon their IAP, SOFA score, serial arterial lactates, the duration of having their abdomen open, the need for mechanical ventilation (MV) along with length of ICU and hospital stay and mortality. Data were collected from the time of abdominal decompression until the end of pressure monitoring. Results: The Bogota and VAC groups were similar with regards to demography, admission diagnosis, severity of illness, and IAH grading. The VAC system was more effective in controlling IAP (P < 0.01) and normalizing serum lactates (P < 0.001) as compared to the Bogota bag during the first 24 hours after surgical decompression. There was no significant difference between the SOFA scores. When compared to the Bogota, the VAC group had a faster abdominal closure time (4.4 vs 6.6 days, P = 0.025), shorter duration of MV (7.1 vs 9.9 days, P = 0.039), decreased ICU length of stay (LOS) (13.3 vs 19.2 days, P = 0.024) and hospital LOS (28.5 vs 34.9 days; P = 0.019). Mortality rate did not differ significantly between the two groups. Conclusions: Patients with abdominal compartment syndrome who were treated with VAC decompression had a faster abdominal closure rate and earlier discharge from the ICU as compared to similar patients treated with the Bogota bag. en_US
dc.language.iso en_US en_US
dc.publisher BioMed Central en_US
dc.relation.isversionof doi:10.1186/cc8193 en_US
dc.relation.hasversion http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811940/pdf/ en_US
dash.license LAA
dc.title Vacuum-assisted closure device enhances recovery of critically ill patients following emergency surgical procedures en_US
dc.type Journal Article en_US
dc.description.version Version of Record en_US
dc.relation.journal Critical Care en_US
dash.depositing.author Ban, Kevin M.
dc.date.available 2011-04-28T06:34:48Z
dash.affiliation.other HMS^Medicine- Beth Israel-Deaconess en_US

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