Cioffi Krista M, Schmiedt Chad W, Cornell Karen K, Radlinsky MaryAnn G
Department of Small Animal Surgery at the University of Georgia Veterinary Teaching Hospital, Athens, GA 30602, USA.
J Vet Emerg Crit Care (San Antonio). 2012 Oct;22(5):601-9. doi: 10.1111/j.1476-4431.2012.00791.x. Epub 2012 Aug 29.
To describe the use of vacuum-assisted peritoneal drainage (VAPD) in dogs and cats with septic peritonitis.
Retrospective descriptive study.
University Veterinary Teaching Hospital.
Six dogs and 2 cats with septic peritonitis.
Application of VAPD after abdominal exploration.
Pre- and post-operative physical and clinicopathologic data, surgical findings, treatment, VAPD fluid production, outcome, and survival are reported.
Eight nonconsecutive cases of septic peritonitis, consisting of 6 dogs and 2 cats, were treated surgically and had VAPD applied post-operatively. The mean duration of clinical signs prior to surgical intervention was 4 ± 3 days. VAPD therapy was applied for a mean of 2 ± 1.1 days and collected a median of 27 mL/kg/d of abdominal effusate. The median time in hospital was 5 days and abdominal closure was completed in 5 of the 8 patients. All specimens collected at surgery cultured positive for bacteria, most commonly Enterococcus spp. The peritoneum of 4 animals was cultured at the time of abdominal closure; 1 was negative and 3 were positive for Escherichia coli, Enterococcus spp. or gram-positive cocci. Cultures before and after surgery differed in 2 patients. Hypoproteinemia was present in all patients postoperatively. Three patients were considered survivors, all of which were dogs. Five patients died or were euthanized due to cardiopulmonary arrest (n = 3), pyothorax (n = 1), and acute, severe, septic peritonitis (n = 1).
VAPD is available for maintaining abdominal drainage for the treatment of septic peritonitis after surgical intervention; however, similar to open abdominal drainage and closed suction drainage, nosocomial infection and hypoproteinemia remain challenges in the treatment of septic peritonitis.
描述真空辅助腹膜引流(VAPD)在患有败血性腹膜炎的犬猫中的应用。
回顾性描述性研究。
大学兽医教学医院。
6只患有败血性腹膜炎的犬和2只患有败血性腹膜炎的猫。
腹部探查后应用VAPD。
报告术前和术后的体格检查及临床病理数据、手术发现、治疗情况、VAPD引流量、结局和存活情况。
8例非连续性败血性腹膜炎病例,包括6只犬和2只猫,接受了手术治疗并在术后应用了VAPD。手术干预前临床症状的平均持续时间为4±3天。VAPD治疗平均应用2±1.1天,中位收集腹腔积液量为27 mL/kg/d。中位住院时间为5天,8例患者中有5例完成了腹壁闭合。手术采集的所有标本细菌培养均为阳性,最常见的是肠球菌属。4只动物在腹壁闭合时进行了腹膜培养;1只为阴性,3只为大肠杆菌、肠球菌属或革兰氏阳性球菌阳性。2例患者手术前后的培养结果不同。所有患者术后均出现低蛋白血症。3例患者被视为存活,均为犬。5例患者因心肺骤停(n = 3)、脓胸(n = 1)和急性、严重、败血性腹膜炎(n = 1)死亡或实施安乐死。
VAPD可用于术后维持腹腔引流以治疗败血性腹膜炎;然而,与开放腹腔引流和闭式负压引流类似,医院感染和低蛋白血症仍是败血性腹膜炎治疗中的挑战。