DuBose et al reported factors associated with pathologic pneumatosis intestinalis. These can help to identify a patient who may require more aggressive management. The authors are from multiple institutions participating in the EAST Pneumatosis Study Group.
Patient selection: pneumatosis intestinalis on imaging studies
Predictors of pathologic pneumatosis:
(1) blood lactate >= 2.0 mmol/L
(2) hypotension or need for vasopressor support (circulatory failure)
(3) peritonitis
(4) acute renal failure
(5) need for mechanical ventilation (respiratory failure)
(6) absent bowel sounds
where:
• Several of these predictors indicate either organ failure (items 2, 4, 5) or perforated bowel (3).
The presence of both hypotension/vasopressor and lactate >= 2 mmol/L had a predictive value of 93%.
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