Systemic warming as an adjunct to resuscitation in peritonitis: a pilot, randomized controlled trial

Area of Science:

• Critical Care Medicine
• Surgical Innovation
• Patient Physiology

Background:

• Bacterial peritonitis presents significant risks, including sepsis, endotoxin production, physiological derangements, and high mortality.
• Systemic warming is known to enhance tissue perfusion and oxygenation, potentially improving surgical outcomes.
• This study investigated systemic warming as an adjunct therapy for peritonitis.

Purpose of the Study:

• To evaluate the efficacy of systemic warming in conjunction with standard antibiotic and fluid resuscitation for peritonitis patients.
• To assess the impact of systemic warming on physiological parameters and patient prognosis.
• To determine the safety and feasibility of implementing systemic warming in peritonitis management.

Main Methods:

• A pilot randomized controlled trial was conducted with patients presenting with acute abdomen.
• Patients were randomized into control and systemic warming groups.
• Systemic warming was administered using a 40°C warming mattress, alongside standard oxygen, fluid resuscitation, and antibiotics.
• The Acute Physiology and Chronic Health Evaluation (APACHE) II score was used to assess patient severity and outcomes.

Main Results:

• Thirty-three patients were enrolled; admission APACHE II scores were similar between groups.
• No adverse effects were reported in patients receiving systemic warming.
• The systemic warming group showed statistically significant improvements in APACHE II scores and the magnitude of score changes compared to the control group.

Conclusions:

• Systemic warming shows potential in mitigating physiological derangements associated with intra-abdominal crises.
• This adjunctive therapy may improve the prognosis for patients suffering from peritonitis.
• Systemic warming can be safely integrated into standard resuscitation protocols for peritonitis.