Direct Peritoneal Resuscitation: A Novel Adjunct to Damage Control Laparotomy
Steven Wiseman1, Ellen M Harvey2, Katie Love Bower3
1Steven Wiseman is a nurse practitioner, Neurological Intensive Care and Intermediate Care Units, University of Virginia Health System, Charlottesville, Virginia. At the time of this work, he was a clinical nurse and unit preceptor, Neuro-Trauma Intensive Care Unit, Carilion Roanoke Memorial Hospital, Roanoke, Virginia.
Abstract:
Direct peritoneal resuscitation is a validated resuscitation strategy for patients undergoing damage control surgery for hemorrhage, sepsis, or abdominal compartment syndrome with open abdomen and planned reexploration after a period of resuscitation in the intensive care unit. Direct peritoneal resuscitation can decrease visceral edema, normalize body water ratios, accelerate primary abdominal wall closure after damage control surgery, and prevent complications associated with open abdomen. This review article describes the physiological benefits of direct peritoneal resuscitation, how this technique fits within management priorities for the patient in shock, and procedural components in the care of open abdomen surgical patients receiving direct peritoneal resuscitation. Strategies for successful implementation of a novel multidisciplinary intervention in critical care practice are explored.
