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The role of direct peritoneal resuscitation in the treatment of hemorrhagic shock after trauma and in emergency acute care surgery: a systematic review.
Ribeiro-Junior, Marcelo Augusto Fontenelle; Costa, Cássia Tiemi Kawase; de Souza Augusto, Samara; Néder, Paola Rezende; Elia, Yasmin Garcia Batista; Rattan, Rishi; Di Saverio, Salomone.
Afiliación
  • Ribeiro-Junior MAF; Division of Trauma and General Surgery, Hospital Municipal Dr. Jose de Carvalho Florence, Faculdade de Ciências Médicas de São José dos Campos, Humanitas, Catholic University of São Paulo, Rua Joubert Wey, 290, Vila Boa Vista, Sorocaba, SP, Brazil. drmribeiro@gmail.com.
  • Costa CTK; Medical School, University of Santo Amaro, Rua Professor Enéas de Siqueira Neto, 340, Jardim das Imbuias, São Paulo, SP, Brazil.
  • de Souza Augusto S; Medical School, University of Santo Amaro, Rua Professor Enéas de Siqueira Neto, 340, Jardim das Imbuias, São Paulo, SP, Brazil.
  • Néder PR; Medical School, University of Santo Amaro, Rua Professor Enéas de Siqueira Neto, 340, Jardim das Imbuias, São Paulo, SP, Brazil.
  • Elia YGB; Medical School, University of Santo Amaro, Rua Professor Enéas de Siqueira Neto, 340, Jardim das Imbuias, São Paulo, SP, Brazil.
  • Rattan R; Division of Trauma Surgery and Critical Care, Leonard M. Miller School of Medicine, University of Miami, Miami, USA.
  • Di Saverio S; Cambridge University Hospitals NHS Trust, Cambridge, UK. salomone.disaverio@gmail.com.
Eur J Trauma Emerg Surg ; 48(2): 791-797, 2022 Apr.
Article en En | MEDLINE | ID: mdl-34773466
PURPOSE: Direct peritoneal resuscitation (DPR) has been used to help preserve microcirculation by reversing vasoconstriction and hypoperfusion associated with the pathophysiological process of shock, which can occur despite appropriate intravenous resuscitation. This approach depends on infusing a hyperosmolar solution intraperitoneally via a percutaneous catheter with the tip ending near the pelvis or the root of the mesentery. The abdomen is usually left open with a negative pressure abdominal dressing to continuously evacuate the infused dialysate. Hypertonicity of the solution triggers visceral vasodilation to help maintain blood flow, even during shock, and is also associated with reduced local inflammatory cytokines and other mediators, preservation of endothelial cell function, and mitigation of organ edema and necrosis. It also has a direct effect on liver perfusion and edema, more rapidly corrects electrolyte abnormalities compared to intravenous resuscitation alone, and may requireless intravenous fluid to stabilize blood pressure, all of which shortens the time required to close patients' abdomen. METHODS: An online query using the search term "direct peritoneal resuscitation" was carried out in PubMed, MEDLINE and SciELO, limited to publications indexed from January 2014 to June 2020. Of the 20 articles returned, full text was able to be obtained for 19. A manual review of included articles' references was resulted in the addition of 1 article, for a total of 20 included articles. RESULTS: The 20 articles were comprised of 15 animal studies, 4 clinical studies,and 1 expert opinion. The benefits include both local and possibly systemic effects on perfusion, hypoxia, acidosis, and inflammation, and are associated with improved outcomes and reduced complications. CONCLUSION: DPR shows promise in patients with hemorrhagic shock, septic shock, and other conditions resulting in an open abdomen after damage control laparotomy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Choque Hemorrágico Tipo de estudio: Guideline / Systematic_reviews Límite: Animals / Humans Idioma: En Revista: Eur J Trauma Emerg Surg Año: 2022 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Choque Hemorrágico Tipo de estudio: Guideline / Systematic_reviews Límite: Animals / Humans Idioma: En Revista: Eur J Trauma Emerg Surg Año: 2022 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Alemania