Wiseman Steven, Harvey Ellen M, Bower Katie Love
Steven 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.
Ellen M. Harvey is a clinical nurse specialist, Neuro-Trauma Intensive Care Unit, Carilion Roanoke Memorial Hospital.
Crit Care Nurse. 2019 Dec 1;39(6):37-45. doi: 10.4037/ccn2019397.
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.
直接腹腔复苏是一种经过验证的复苏策略，适用于因出血、脓毒症或腹腔间隔室综合征而接受损伤控制手术且腹部开放、计划在重症监护病房进行一段时间复苏后再次手术探查的患者。直接腹腔复苏可减轻内脏水肿，使身体水比例正常化，加速损伤控制手术后的腹壁一期缝合，并预防与腹部开放相关的并发症。这篇综述文章描述了直接腹腔复苏的生理益处、该技术如何契合休克患者的管理重点，以及接受直接腹腔复苏的腹部开放手术患者护理中的操作环节。探讨了在重症监护实践中成功实施一种新型多学科干预措施的策略。
