Inefficacy of intraperitoneal fluid administration in a shock model

Intraperitoneal (IP) fluid administration has been previously used to treat dehydrated children. The relative ease and reported safety of this route suggests its potential utility for volume resuscitation in the acutely ill child. Previous research regarding IP fluid infusion has not examined its use in shock states. This experiment sought to examine the efficacy of an IP fluid infusion in a shock model. Ten immature swine were randomized to receive either no treatment (n = 5) or 30 ml/kg of warmed lactated Ringer's solution (n = 5) IP 20 minutes after a graded 40% hemorrhage. Mean arterial pressure (MAP), heart rate (HR), hematocrit (Hct), pH, and PCO2 were determined serially, and the experiment concluded 60 minutes after intervention. A mean of 89.5% of the administered fluid load was recovered from the peritoneal cavity, and the IP infusion had no ameliorative effect on MAP or HR. The lack of clinically significant absorption of an administered isotonic intraperitoneal fluid infusion in this model suggests that this route should not be relied upon in the critically ill child presenting in shock.