Abstract：
OBJECTIVE: Direct peritoneal resuscitation (DPR) has been used to help preserve microcirculation by reversing vasoconstriction and hypoperfusion associated with the pathophysiological process of shock, which can occur despite appropriate intravenous resuscitation. This approach depends on infusing a hyperosmolar solution intraperitoneally via a percutaneous catheter with the tip ending near the pelvis or the root of the mesentery. The abdomen is usually left open with a negative pressure abdominal dressing to continuously evacuate the infused dialysate. Hypertonicity of the solution triggers visceral vasodilation to help maintain blood flow, even during shock, and is also associated with reduced local inflammatory cytokines and other mediators, preservation of endothelial cell function, and mitigation of organ edema and necrosis. It also has a direct effect on liver perfusion and edema, more rapidly corrects electrolyte abnormalities compared to intravenous resuscitation alone, and may requireless intravenous fluid to stabilize blood pressure, all of which shortens the time required to close patients\' abdomen.
METHODS: An online query using the search term \"direct peritoneal resuscitation\" was carried out in PubMed, MEDLINE and SciELO, limited to publications indexed from January 2014 to June 2020. Of the 20 articles returned, full text was able to be obtained for 19. A manual review of included articles\' references was resulted in the addition of 1 article, for a total of 20 included articles.
RESULTS: The 20 articles were comprised of 15 animal studies, 4 clinical studies,and 1 expert opinion. The benefits include both local and possibly systemic effects on perfusion, hypoxia, acidosis, and inflammation, and are associated with improved outcomes and reduced complications.
CONCLUSIONS: DPR shows promise in patients with hemorrhagic shock, septic shock, and other conditions resulting in an open abdomen after damage control laparotomy.
METHODS: An online query using the search term \"direct peritoneal resuscitation\" was carried out in PubMed, MEDLINE and SciELO, limited to publications indexed from January 2014 to June 2020. Of the 20 articles returned, full text was able to be obtained for 19. A manual review of included articles\' references was resulted in the addition of 1 article, for a total of 20 included articles.
RESULTS: The 20 articles were comprised of 15 animal studies, 4 clinical studies,and 1 expert opinion. The benefits include both local and possibly systemic effects on perfusion, hypoxia, acidosis, and inflammation, and are associated with improved outcomes and reduced complications.
CONCLUSIONS: DPR shows promise in patients with hemorrhagic shock, septic shock, and other conditions resulting in an open abdomen after damage control laparotomy.
摘要：
目的：直接腹膜复苏（DPR）已用于通过逆转与休克的病理生理过程相关的血管收缩和灌注不足来帮助维持微循环，尽管进行了适当的静脉复苏，但仍可能发生。这种方法取决于通过经皮导管腹膜内输注高渗性溶液，其尖端在骨盆或肠系膜根部附近终止。腹部通常用负压腹部敷料保持开放,以连续地排出输注的透析液。溶液的高渗性引发内脏血管舒张，以帮助维持血液流动，即使在休克期间，并且还与局部炎症细胞因子和其他介质减少有关，内皮细胞功能的保护，减轻器官水肿和坏死。它还对肝脏灌注和水肿有直接影响，与单纯静脉复苏相比，更快速地纠正电解质异常，可能需要静脉输液来稳定血压，所有这些都缩短了关闭患者腹部所需的时间。
方法：在PubMed中使用搜索词“直接腹膜复苏”进行了在线查询，MEDLINE和SciELO,仅限于2014年1月至2020年6月索引的出版物。在返回的20篇文章中，全文能够获得19。对所包含的文章参考文献进行手动审查后，增加了1篇文章，共20篇文章。
结果：这20篇文章包括15项动物研究，4临床研究，1个专家意见。益处包括对灌注的局部和可能的全身影响，缺氧,酸中毒,和炎症，与改善预后和减少并发症相关。
结论：DPR在失血性休克患者中显示出希望，感染性休克,以及其他导致损伤控制剖腹手术后腹部开放的情况。
方法：在PubMed中使用搜索词“直接腹膜复苏”进行了在线查询，MEDLINE和SciELO,仅限于2014年1月至2020年6月索引的出版物。在返回的20篇文章中，全文能够获得19。对所包含的文章参考文献进行手动审查后，增加了1篇文章，共20篇文章。
结果：这20篇文章包括15项动物研究，4临床研究，1个专家意见。益处包括对灌注的局部和可能的全身影响，缺氧,酸中毒,和炎症，与改善预后和减少并发症相关。
结论：DPR在失血性休克患者中显示出希望，感染性休克,以及其他导致损伤控制剖腹手术后腹部开放的情况。
