Continuous peritoneal lavage with vacuum peritoneostomy: an experimental study
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , |
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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Clinics |
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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 |
_version_ |
1800222764194332672 |