Preliminary resuscitation for perforated necrotizing enterocolitis: 2 cases treated with initial direct peritoneal resuscitation.
We used peritoneal infusions of 2.5% dextrose solution as an adjunct to resuscitation of 2 very low-birth-weight infants having perforated necrotizing enterocolitis. This was repeated every 12 hours for 7 days before and 1 day after extensive bowel resection. The designation of this research method has been termed direct peritoneal resuscitation. We discuss our observations and the evolution of this technique from studies in the animal laboratory to a recent trial in patients with abdominal trauma. We propose that the early response benefit of this preoperative resuscitation seen in our 2 cases be investigated by others. Prospective controlled trials could then be considered for those high-risk patients having diffuse disease and shock.
Department of Surgical Education, Research-Iowa Methodist Medical Center and Blank Children's Hospital, Iowa Health System, DesMoines, IA 50309-1453, USA. hopkinjw@ihs.org
James W
JW
Hopkins
Basaviah
B
Chandramouli
Piper
P
Wall
D000818:Animals; D004195:Disease Models, Animal; D004322:Drainage / Q000379:methods; D020345:Enterocolitis, Necrotizing / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007263:Infusions, Parenteral / Q000379:methods; D007416:Intestinal Perforation / Q000188:drug therapy / Q000601:surgery*; D008297:Male; D011300:Preoperative Care / Q000379:methods*; D051381:Rats; D012151:Resuscitation; D012771:Shock, Hemorrhagic / Q000628:therapy; D012772:Shock, Septic / Q000628:therapy
D005947:Glucose