Table 2: Criteria for reintervention in peritonitis. |
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Criteria for conservative behaviour |
Criteria for conservative behavior |
Criteria for rapid reintervention |
Criteria for rapid reintervention |
• Diuresis preserved (+ 40 ml/hour) • Stable cardiocirculatory state without the need for vasopressor amines and, above all, without having to progressively increase the doses • Lack of general toxic and infectious signs • Lack of abdominal signs of diffusion; intestinal transit preserved or restored and decreased nasogastric tube fluid output |
• Rapid disappearance of the alarm sign that led to a suspected diagnosis of postoperative peritonitis • Slightly elevated neutrophil polymorphonuclear count or, if clearly elevated, a marked drop in values compared to the previous figure • Easily correctable functional renal failure • Lack of indication for assisted ventilation or prolongation of ventilation in a patient without preoperative respiratory failure |
• Oligo-anuria • Insufficient cardiocirculatory status with increasing deterioration • Insufficient cardiocirculatory status with increasing deterioration • Lack of satisfactory clinical and laboratory response to intensive medical treatment • Abdominal signs of propagation; lack of resumption of intestinal transit or secondary arrest |
• Elevated rate of leukocytosis • Persistence of renal failure despite intensive medical treatment or worsening of renal failure • Need for assisted ventilation |
Source: Study data. Adapted from: Parc Y, et al.17 |