Management of the Critical Care Patient Following Major Abdominal Surgery

6.8 - Management of the Critical Care Patient Following Major Abdominal Surgery

from Section 6 - Perioperative Care

Published online by Cambridge University Press: 27 July 2023

Anthony O’Dwyer and

Edited by

Debashish Dutta and

Ned Gilbert-Kawai: Affiliation:
The Royal Liverpool Hospital
Debashish Dutta: Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann: Affiliation:
Royal Berkshire Hospital, Reading

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Summary

Key Learning Points

1. Analgesia should be multi-modal and opioid-sparing.
2. Adequate resuscitation and management of effective circulation.
3. Intensive care unit-related complications should be prevented.
4. Nutritional support should be addressed.
5. Abdominal catastrophes should be recognised and prevented.

Keywords

abdominal surgery anastomotic leak gastrointestinal surgery abdominal catastrophe

Type: Chapter
Information: Intensive Care Medicine
The Essential Guide
, pp. 648 - 652

DOI: https://doi.org/10.1017/9781108989060 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2021

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References

References and Further Reading

Bouze, E, Pérez, E, Muñoz, P, et al. Continuous aspiration of subglottic secretions in prevention of ventilator-associated pneumonia in postoperative period of major heart surgery. Chest 2008;134:938–46Google Scholar

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Clain, J, Ramar, K, Surani, S. Glucose control in critical care. World J Diabetes 2015;6:1082–91.CrossRef Google Scholar PubMed

de Lacerda Vidal, CF, de Lacerda Vidal, AK, de Moura Monteiro, JG, et al. Impact of oral hygiene involving toothbrushing versus chlorhexidine in the prevention of ventilator associated pneumonia: a randomized study. BMC Infect Dis 2017;17:112.CrossRef Google Scholar PubMed

English, W. Abdominal compartment syndrome. Update in Anaesthesia. resources.wfsahq.org/wp-content/uploads/uia28-Abdominal-compartment-syndrome.pdf Google Scholar

English, W, McCormick, B. 2008. Abdominal compartment syndrome tutorial of the week. Number 120. resources.wfsahq.org/atotw/abdominal-compartment-syndrome-tutorial-of-the-week-number-120/Google Scholar

Garde, M, Quintel, M, Ghadimi, M. Standard perioperative management in gastrointestinal surgery. Langenbecks Arch Surg 2011;296:591–606.CrossRef Google Scholar

Harvey, SE, Parrot, F, Harrison, DA, et al. Trial of the route of early nutritional support in critically ill adults. N Engl J Med 2014;371:1673–84.CrossRef Google Scholar PubMed

Holst, LB, Haase, N, Wetterslev, J, et al. Lower versus higher haemoglobin threshold for transfusion in septic shock (TRISS trial). N Engl J Med 2014;371:1381–91.CrossRef Google Scholar

McDermott, FD, Arora, S, Smith, J, et al.; Association of Surgeons of Great Britain and Ireland, The Association of Coloproctology of Great Britain and Ireland. 2016. Prevention, diagnosis and management of colorectal anastomotic leakage. www.acpgbi.org.uk/_userfiles/import/2017/02/Prevention-diagnosis-and-management-of-colorectal-anastomotic-leakage-ASGBI-ACPGBI-2016.pdf Google Scholar

National Institute for Health and Care Excellence. Nutrition support in adults. London: National Institute for Health and Care Excellence; 2006.Google Scholar