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These findings suggest that in selected critically ill patients with a vital indication for emergency laparotomy and severe cardiopulmonary instability precluding transport to the OR, a bedside resuscitative laparotomy in the ICU can be considered as a rescue procedure, even though very high mortality is to be expected.
Assessing the vital indication for emergency laparotomy and the risks of transport to the OR in these patients and performing a bedside resuscitative laparotomy in the ICU was a highly individualized and collective decisional process of the senior consultants of the Department of Intensive Care Medicine and the Department of Surgery.
In patients with acute and life-threatening intra-abdominal conditions and vital indication for emergency laparotomy, but with severe hemodynamic and/or respiratory instability precluding safe transport to the OR, bedside rescue laparotomy in the ICU might be the only viable intervention [ 6].
In selected critically ill patients with a vital indication for emergency laparotomy and severe cardiopulmonary instability, precluding transport to the OR, a bedside rescue laparotomy in the ICU can be considered even though it is associated with a very high mortality, especially in patients with a profound metabolic acidosis.
The results of our study suggest that in extreme situations with a vital indication for emergency laparotomy but severe cardiopulmonary instability preventing transport to the OR a rescue laparotomy in the ICU should be considered as a potential treatment option as a last resort.
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The ROK-US Combined Forces Command raised its surveillance condition from WATCHCON3 (important indications of threat) to WATCHCON2 (vital indications of threat).
This view is also imposed on the gynaecologist, although sometimes the head of a gynaecological clinic lets the gynaecologist perform hymen reconstruction as long as the gynaecologist keeps a low profile and nothing is made public, even though the gynaecologist considers the operation as being performed on a vital indication, i.e. out of concern for the patient's life [ 3, 7].
The intentions for metastasectomy were pain control and/or the management of pathological fractures (65.1%) and vital indication given by metastases to the brain in 9.3% of the patients.
Because of such later pregnancy birth defects, anticoagulation with warfarin poses a problem in pregnant women requiring warfarin for vital indications, such as stroke prevention in those with artificial heart valves.
We report the clinical characteristics and outcomes of a cohort of 41 critically ill patients with severe multiorgan failure who underwent resuscitative bedside laparotomy for vital indications.
After the conditioning therapy for allogenic marrow transplantation, the patients reach complete aplasia, are usually isolated on a bone marrow transplantation unit and should only undergo MR imaging for vital indications.
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CEO of Professional Science Editing for Scientists @ prosciediting.com