Hemodialysis and ECMO applications are inevitable interventions for patients with life-threatening organ failure or temporary, irreversible organ function. In our study, all the studied subjects did not have predisposing organ failure. All conditions with organ failure and later hemodialysis or ECMO application were related to the deterioration of clinical course. In our study, 11 subjects did not survive. We summarized Pirfenidone cost the clinical profiles of these patients (Table 4). Almost half of these patients finally died due to brain death (4 patients due to
initial brain injury, and 1 patient due to hypoxic encephalopathy). For these patients who died of brain death, 80% (4/5) died within the first week of admission (mean Everolimus datasheet hospital stay, 6 days; median hospital stay, 4 days). For the other 6 patients, 5 of them died from infectious complication (4 from intra-abdominal origin, and 1 patient from low respiratory tract infection). Although a previous study identified low respiratory tract infection as the most common [18] type of post-DCL infection, intra-abdominal infection may contribute lethal effect to patients. Case #3 in Table 4 was a patient with Child A cirrhosis due to alcoholic hepatitis. He suffered from concurrent and relative low grade hepatic and splenic injury, which
is why low ISS was noted. Although methods of laparotomy wound management and timing of abdominal closure after DCL influence the clinical outcome [19], these factors could not be well assessed in our series due to the small number of patients. In addition, patients who succumbed to infectious complications were typically older (Table 4). According to our study, late death for patients undergoing DCL
may be attributed to an initial brain insult or an infectious complication, especially intra-abdominal infections. Table 4 Summary of patients with mortality Injury type Age/gender Initial GCS RTS CPCR at ED ISS APACHI II OP times Accumulated transfusion* HD ECMO Pregnenolone Cause and time of death (days) #1 Blunt 22/F 8 5.971 N 57 21 2 12 N N Brain stem failure (2) #2 Penetrating 85/M 15 6.376 N 18 14 2 18 N N Sepsis with intra-abdominal infection (14) #3 Blunt 60/M 15 4.918 N 4 31 3 68 Y N Hepatic failure (13) #4 Blunt 18/M 3 3.361 N 45 22 2 44 N N Brain stem failure (6) #5 Penetrating 50/M 10 6.904 N 18 15 3 16 Y N Sepsis due to pneumonia (31) #6 Blunt 51/M 4 5.039 N 34 25 3 42 N N Sepsis with intra-abdominal infection (2) #7 Blunt 19/M 3 1.95 Y 41 25 2 30 N N Brain stem failure (14) #8 Blunt 25/M 6 5.097 Y 29 28 2 56 N N Brain stem failure (4) #9 Blunt 23/M 3 0.872 Y 36 25 2 24 N Y Brian stem failure (4) #10 Blunt 61/M 15 7.8412 N 30 24 2 32 Y N Sepsis due to ischemic bowel (3) #11 Blunt 57/M 11 5.449 N 41 16 2 20 Y Y Sepsis due to intra-abdominal infection (25) * Amount of total packed red blood cell and whole blood transfusion before ICU admission.