Editing Open abdomen (section)

=== '''Phase 2: ICU resuscitation''' ===

* Management in ICU with the open abdomen
** Nutrition - Sabiston says early enteral nutrition in the open abdomen is beneficial, if feasible
** No specific antibiotic prophylaxis - data says unnecessary
** Strict fluid balance aiming euvolaemia
** Can be extubated between washouts if co-operative
** Correct hypothermia, coagulopathy and acidosis
** Minimising crystalloid infusion has been shown to increase rates of primary fascial closure
** Routine monitoring of intra-abdominal pressures in those with large-volume resuscitation due to haemodynamic instability or ongoing bleeding
*** See separate topic, but essentially, if bladder pressure >20mmHg, monitor hourly, and if any sign of end-organ dysfunction, needs return to theatre