colectomy or a diverting ileostomy for refractory cases of C-difficile
colitis, and a number of other operations depending on the clinical
scenario. Patients with Hirschsprung enterocolitis require not only
IV antibiotics, but also colonic irrigations in order to decrease
bacterial content and potential translocation.
- Prevent secondary injury to organs: These measures include
providing lung-protective mechanical ventilation, avoidance of
nephrotoxic medications and/or dosing medications based on the
degree of renal dysfunction, utilizing measures to decrease blood
stream infections in patients with central venous catheters.
Consider early enteral feeding but
only after an abdominal source has been ruled out and the patient
is able to maintain an adequate blood pressure without major
vasopressor support.
- Provide sedation/analgesia to minimize effects of stress and
alleviate some of the inflammatory response.[7,18] Choice of
sedatives is often institution dependent, but continuous infusions
are generally recommended to prevent drastic changes in
