• Pneumatosis intestinalis Predictive Evaluation Study (PIPES): A Multicenter Epidemiologic Study of the American Association for the Surgery of Trauma (March 2017)

    Paula Ferrada, MD, Rachael Callcut, MD, Graciela Bauza, MD, Karen R. O’Bosky, MD, Xian Luo-Owen, PhD, Nicky J. Mansfield, MD, Kenji Inaba, MD, Jason Pasley, DO, Nikolay Bugaev, MD, Bruno Pereira, MD, Forrest O. Moore, MD, Jinfeng Han, RN, Amelia Pasley, DO, Joseph DuBose, MD, and AAST Multi-institutional Trials Committee
    CME 1 CME Credit(s)

    Learning Objectives:

    The purpose of the study is to validate the predictors for bowel necrosis we previously identified in the retrospective review, on this prospective study.

    Impact Statement:

    The pathogenesis of pneumatosis intestinalis (PI) or air in the intestinal wall is poorly understood. Since discovering PI in CT scan can fluctuate from necrotic bowel to a benign finding, it is pivotal to help the surgeon decide when to intervene to prevent poor patient outcomes.

    The present group has devoted the last few years to understand the significance of this finding in changing surgical management, in conjunction with other clinical predictors of pathology.1

    We previously published a retrospective review of 500 patients with PI. In this review, we identified a lactate greater than 2.0 mmol/L as the strongest independent predictors of pathologic PI. Other factors such as peritonitis, hypotension or vasopressor need, acute renal failure, active mechanical ventilation, and absent bowel sounds also demonstrated significance.

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    This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint providership of the American College of Surgeons and the American Association for the Surgery of Trauma. The American College of Surgeons is accredited by the ACCME to provide continuing medical education (CME) for physicians.

    AMA PRA Category 1 Credits™

    The American College of Surgeons designates this journal-based activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Of the AMA PRA Category 1 Credits™ listed above, a maximum of 1 credit meets the requirements for Self-Assessment.

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