Continuous peritoneal lavage with vacuum peritoneostomy: an experimental study

Detalhes bibliográficos
Autor(a) principal: Rodrigues, Adilson Costa
Data de Publicação: 2019
Outros Autores: Saad, Karen Ruggeri, Saad, Paulo Fernandes, Otsuki, Denise Aya, Santos, Luana Carla dos, Rasslan, Samir, Montero, Edna Frasson de Souza, Utiyama, Edivaldo M.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Clinics
Texto Completo: https://www.revistas.usp.br/clinics/article/view/160130
Resumo: OBJECTIVE: Despite advances in diffuse peritonitis treatment protocols, some cases develop unfavorably. With the advent of vacuum therapy, the use of laparostomy to treat peritonitis has gained traction. Another treatment modality is continuous peritoneal lavage. However, maintaining this technique is difficult and has been associated with controversial results. We propose a new model of continuous peritoneal lavage that takes advantage of the features and benefits of vacuum laparostomy. METHOD: Pigs (Landrace and Large White) under general anesthesia were submitted to laparostomy through which a multiperforated tube was placed along each flank and exteriorized in the left and lower right quadrants. A vacuum dressing was applied, and intermittent negative pressure was maintained. Peritoneal dialysis solution (PDS) was then infused through the tubes for 36 hours. The stability of peritoneostomy with intermittent infusion of fluids, the system resistance to obstruction and leakage, water balance, hemodynamic and biochemical parameters were evaluated. Fluid disposition in the abdominal cavity was analyzed through CT. RESULTS: Even when negative pressure was not applied, the dressing maintained the integrity of the system, and there were no leaks or blockage of the catheters during the procedure. The aspirated volume by vacuum laparostomy was similar to the infused volume (9073.5±1496.35 mL versus 10165±235.73 mL, p=0.25), and there were no major changes in hemodynamic or biochemical analysis. According to CT images, 60 ml/kg PDS was sufficient to occupy all intra-abdominal spaces. CONCLUSION: Continuous peritoneal lavage with negative pressure proved to be technically possible and may be an option in the treatment of diffuse peritonitis.
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spelling Continuous peritoneal lavage with vacuum peritoneostomy: an experimental studyPeritonitisOpen AbdomenLaparostomyPeritoneal LavageVacuum-Assisted ClosureAbdominal SepsisOBJECTIVE: Despite advances in diffuse peritonitis treatment protocols, some cases develop unfavorably. With the advent of vacuum therapy, the use of laparostomy to treat peritonitis has gained traction. Another treatment modality is continuous peritoneal lavage. However, maintaining this technique is difficult and has been associated with controversial results. We propose a new model of continuous peritoneal lavage that takes advantage of the features and benefits of vacuum laparostomy. METHOD: Pigs (Landrace and Large White) under general anesthesia were submitted to laparostomy through which a multiperforated tube was placed along each flank and exteriorized in the left and lower right quadrants. A vacuum dressing was applied, and intermittent negative pressure was maintained. Peritoneal dialysis solution (PDS) was then infused through the tubes for 36 hours. The stability of peritoneostomy with intermittent infusion of fluids, the system resistance to obstruction and leakage, water balance, hemodynamic and biochemical parameters were evaluated. Fluid disposition in the abdominal cavity was analyzed through CT. RESULTS: Even when negative pressure was not applied, the dressing maintained the integrity of the system, and there were no leaks or blockage of the catheters during the procedure. The aspirated volume by vacuum laparostomy was similar to the infused volume (9073.5±1496.35 mL versus 10165±235.73 mL, p=0.25), and there were no major changes in hemodynamic or biochemical analysis. According to CT images, 60 ml/kg PDS was sufficient to occupy all intra-abdominal spaces. CONCLUSION: Continuous peritoneal lavage with negative pressure proved to be technically possible and may be an option in the treatment of diffuse peritonitis.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2019-07-22info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/xmlhttps://www.revistas.usp.br/clinics/article/view/16013010.6061/clinics/2019/e937Clinics; Vol. 74 (2019); e937Clinics; v. 74 (2019); e937Clinics; Vol. 74 (2019); e9371980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/160130/154491https://www.revistas.usp.br/clinics/article/view/160130/154492Copyright (c) 2019 Clinicsinfo:eu-repo/semantics/openAccessRodrigues, Adilson CostaSaad, Karen RuggeriSaad, Paulo FernandesOtsuki, Denise AyaSantos, Luana Carla dosRasslan, SamirMontero, Edna Frasson de SouzaUtiyama, Edivaldo M.2019-07-22T11:57:02Zoai:revistas.usp.br:article/160130Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2019-07-22T11:57:02Clinics - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Continuous peritoneal lavage with vacuum peritoneostomy: an experimental study
title Continuous peritoneal lavage with vacuum peritoneostomy: an experimental study
spellingShingle Continuous peritoneal lavage with vacuum peritoneostomy: an experimental study
Rodrigues, Adilson Costa
Peritonitis
Open Abdomen
Laparostomy
Peritoneal Lavage
Vacuum-Assisted Closure
Abdominal Sepsis
title_short Continuous peritoneal lavage with vacuum peritoneostomy: an experimental study
title_full Continuous peritoneal lavage with vacuum peritoneostomy: an experimental study
title_fullStr Continuous peritoneal lavage with vacuum peritoneostomy: an experimental study
title_full_unstemmed Continuous peritoneal lavage with vacuum peritoneostomy: an experimental study
title_sort Continuous peritoneal lavage with vacuum peritoneostomy: an experimental study
author Rodrigues, Adilson Costa
author_facet Rodrigues, Adilson Costa
Saad, Karen Ruggeri
Saad, Paulo Fernandes
Otsuki, Denise Aya
Santos, Luana Carla dos
Rasslan, Samir
Montero, Edna Frasson de Souza
Utiyama, Edivaldo M.
author_role author
author2 Saad, Karen Ruggeri
Saad, Paulo Fernandes
Otsuki, Denise Aya
Santos, Luana Carla dos
Rasslan, Samir
Montero, Edna Frasson de Souza
Utiyama, Edivaldo M.
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Rodrigues, Adilson Costa
Saad, Karen Ruggeri
Saad, Paulo Fernandes
Otsuki, Denise Aya
Santos, Luana Carla dos
Rasslan, Samir
Montero, Edna Frasson de Souza
Utiyama, Edivaldo M.
dc.subject.por.fl_str_mv Peritonitis
Open Abdomen
Laparostomy
Peritoneal Lavage
Vacuum-Assisted Closure
Abdominal Sepsis
topic Peritonitis
Open Abdomen
Laparostomy
Peritoneal Lavage
Vacuum-Assisted Closure
Abdominal Sepsis
description OBJECTIVE: Despite advances in diffuse peritonitis treatment protocols, some cases develop unfavorably. With the advent of vacuum therapy, the use of laparostomy to treat peritonitis has gained traction. Another treatment modality is continuous peritoneal lavage. However, maintaining this technique is difficult and has been associated with controversial results. We propose a new model of continuous peritoneal lavage that takes advantage of the features and benefits of vacuum laparostomy. METHOD: Pigs (Landrace and Large White) under general anesthesia were submitted to laparostomy through which a multiperforated tube was placed along each flank and exteriorized in the left and lower right quadrants. A vacuum dressing was applied, and intermittent negative pressure was maintained. Peritoneal dialysis solution (PDS) was then infused through the tubes for 36 hours. The stability of peritoneostomy with intermittent infusion of fluids, the system resistance to obstruction and leakage, water balance, hemodynamic and biochemical parameters were evaluated. Fluid disposition in the abdominal cavity was analyzed through CT. RESULTS: Even when negative pressure was not applied, the dressing maintained the integrity of the system, and there were no leaks or blockage of the catheters during the procedure. The aspirated volume by vacuum laparostomy was similar to the infused volume (9073.5±1496.35 mL versus 10165±235.73 mL, p=0.25), and there were no major changes in hemodynamic or biochemical analysis. According to CT images, 60 ml/kg PDS was sufficient to occupy all intra-abdominal spaces. CONCLUSION: Continuous peritoneal lavage with negative pressure proved to be technically possible and may be an option in the treatment of diffuse peritonitis.
publishDate 2019
dc.date.none.fl_str_mv 2019-07-22
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/clinics/article/view/160130
10.6061/clinics/2019/e937
url https://www.revistas.usp.br/clinics/article/view/160130
identifier_str_mv 10.6061/clinics/2019/e937
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/clinics/article/view/160130/154491
https://www.revistas.usp.br/clinics/article/view/160130/154492
dc.rights.driver.fl_str_mv Copyright (c) 2019 Clinics
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2019 Clinics
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/xml
dc.publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
dc.source.none.fl_str_mv Clinics; Vol. 74 (2019); e937
Clinics; v. 74 (2019); e937
Clinics; Vol. 74 (2019); e937
1980-5322
1807-5932
reponame:Clinics
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Clinics
collection Clinics
repository.name.fl_str_mv Clinics - Universidade de São Paulo (USP)
repository.mail.fl_str_mv ||clinics@hc.fm.usp.br
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