Research progress on direct peritoneal resuscitation in the treatment of hemorrhagic shock
10.11855/j.issn.0577-7402.2020.12.16
- VernacularTitle:腹腔复苏治疗失血性休克的研究进展
- Author:
Zhao-Xing LIU
1
;
Da-Wei LI
;
Yue-Zeng NIU
;
Wen ZHANG
;
Jing-Long MA
;
Chuan-An SHEN
Author Information
1. 解放军总医院第四医学中心烧伤整形科,北京 100048
- Keywords:
hemorrhagic shock;
fluid resuscitation;
direct peritoneal resuscitation
- From:
Medical Journal of Chinese People's Liberation Army
2020;45(12):1304-1308
- CountryChina
- Language:Chinese
-
Abstract:
Hemorrhagic shock refers to the pathophysiological process of reduced effective circulating blood volume,insufficient tissue perfusion,disorder of cell metabolism,and impaired organ function caused by the body's massive blood loss due to various causes.The key to improving the success rate of its treatment is to recover effective tissue perfusion as soon as possible to improve the oxygen supply to tissue cells,rebalance oxygen supply and demand,and restore normal cell functions while eliminating the cause of shock.The key to emergent care of hemorrhagic shock is timely and effective fluid resuscitation,which can directly affect the prognosis of patients.How to effectively provide fluid resuscitation is a clinical challenge that doctors must take into consideration.Direct peritoneal resuscitation represents a new approach by which the required infusion fluid is administered into the peritoneal cavity by means of abdominocentesis and absorbed through the peritoneal blood vessels and lymphatic vessels.This fluid resuscitation technique is characterized by fixed puncture points and easy operations,and it is less affected by environmental factors.Using this technique,the fluid can be infused at once in a short time.When it is difficult to establish an intravenous infusion pathway,a fluid resuscitation pathway can be quickly established,which can effectively improve hemodynamic indicators and achieve fluid resuscitation against shock.In addition,at the same time of intravenous fluid resuscitation,direct peritoneal resuscitation can improve the effect of intravenous resuscitation,which is of great significance in improving micro-circulation,increasing organ blood flow,reducing organ and tissue edema,and inhibiting systemic inflammation.This article attempts to review the merits,fluid selection and mechanism of direct peritoneal resuscitation,aiming to provide new ideas for fluid resuscitation of hemorrhagic shock.
