Intra-abd OR procedures done at bedside in ICU settings
I’m in critical care in a new system. I loved my old place and I love my new place. Surgeons were great at both, but many folks had only trained/worked at their respective locations so there tends to be a lot of institutional practice patterns (not bad - just different, I’d be happy to be a patient at either place). Both systems have similar resources (though I don’t know the specifics on surgical staffing). I’m curious about this particular practice.
Recently an re-ex-lap was done bedside in the ICU. Belly was already abthera’ed pre-procedure but it was still a proper open abdomen. It seemed (to me as a non surgeon) to go very well. Apparently this isn’t a common practice but not entirely rare. This pt was sick, but at my old place we would have packed them up and gotten them to the OR. I think I heard about one bedside ex lap at my old system. CICU bedside emergent open chests happened with some frequency….but for any abdominal issues I feel like even when folks were super unstable we went to the OR.
Clinically all of these patients are super sick, but from a resource perspective it seemed like staying in the ICU actually made a lot of sense. I did a cursory search for infection rates and didn’t see anything about OR v ICU setting. Why might a surgeon go for a bedside open abdomen procedure vs going to the OR?