Name:
24-03-0150_TTV
Description:
24-03-0150_TTV
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/796a00b3-bbf1-43d8-8920-f374360aafc5/videoscrubberimages/Scrubber_1.jpg?sv=2019-02-02&sr=c&sig=r%2FoARy3Dh1f9h2b%2BzXJvSOiyfr81KxQBHDWiTGT24EA%3D&st=2024-12-26T11%3A41%3A01Z&se=2024-12-26T15%3A46%3A01Z&sp=r
Duration:
T00H05M05S
Embed URL:
https://stream.cadmore.media/player/796a00b3-bbf1-43d8-8920-f374360aafc5
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/796a00b3-bbf1-43d8-8920-f374360aafc5/24-03-0150_TTV.mp4?sv=2019-02-02&sr=c&sig=SbGpbZlhisouSJkOEVQKKYM1y1ZJiXH7smd5SL08HzY%3D&st=2024-12-26T11%3A41%3A01Z&se=2024-12-26T13%3A46%3A01Z&sp=r
Upload Date:
2024-12-26T11:46:01.5785699Z
Transcript:
Language: EN.
Segment:0 .
My name is Jacobo Romano Noriega, and today we'll be sharing a video tutorial on therapeutic interventions using the peritoneal cavity in dogs, cats and exotic pets. The authors do not have any conflicts of interest to disclose. Inserting a hypodermic needle or catheter into the peritoneal cavity allows for administration of fluid or blood products, plasma or red blood cells.
The needle is placed peri-umbilically in mammals within a 1 to 2 centimeter radius from the umbilicus. Fluids have been administered in this way in humans, dogs, cats and small mammals. Intraperitoneal fluids are used in reptiles and amphibians, but not commonly in birds due to their air sac system. The exact location of fluid administration varies depending on the location of vital organs and species. For example, IP fluids in chelonians are limited to the ventral inguinal pre-femoral fossa. In lizards, IP fluids are given as caudal and lateraloventral as possible in the coelom to avoid the lungs and other organic structures.
And in snakes they should receive their fluids lateraloventrally to avoid the lungs and the fat pads. In all species, intravenous or intraosseous access is always preferred to intraperitoneal fluids. IP fluids are limited to cases where intravenous or intraosseous access is not possible. Examples include neonatal dogs and cats and very small exotic species. When given intraperitoneally, fluid is absorbed across the peritoneal membrane.
The peritoneum is lined by mesothelial cells with microvilli surrounding an interstitium filled with capillaries. The peritoneum receives a large proportion of cardiac output, up to 4 to 7% in humans. Fluids increase the hydrostatic pressure in the peritoneum, and per Starling's laws, the fluid then moves into peritoneal capillaries. Excess interstitial fluid, red blood cells, and plasma components are absorbed by the diaphragmatic lymphatics. When giving peritoneal fluids, the dose is similar to what is given subcutaneously for that species, but larger resuscitation volumes have been reported.
This is typically 10 to 20 mLs per kilogram, often less in reptiles. Blood product volumes are calculated and dosed as normal. However, since the intraperitoneal fluids are absorbed more slowly than subcutaneous, intravenous or intraosseous fluids, they are likely not useful for resuscitation. Intraperitoneal red blood cells take up to 72 hours to be absorbed and shouldn't be used for active hemorrhage.
IP fluids should be warm to avoid dropping the body temperature and must be given aseptically to avoid peritonitis. Larger volumes can cause discomfort by increasing intra- abdominal pressure. Hypertonic solutions cannot be given IP since they will draw water into the peritoneal space from the capillaries. The intraperitoneal route has been described for euthanasia in laboratory and small animal species.
However, the relatively slow absorption from the peritoneal cavity, five minutes up to one hour or more, makes the IP route less desirable. Pure sodium pentobarbital without phenytoin is the only commercial euthanasia solution approved for IP euthanasia. Because phenytoin is absorbed faster than pentobarbital, it can lead to cardiac arrest before enough sedation has occurred from the pentobarbital, leading to distress.
Mice over 35 days of age can also receive 70% ethanol intraperitoneally to facilitate euthanasia. Approved sites for IP injection are the periumbilical region or right ventral abdomen, avoiding the GI tract. Direct peritoneal resuscitation is described in humans to treat ischemia reperfusion injury in the intestines, improve visceral blood flow, and blunt aberrant immune responses resulting from abdominal injury or shock.
It was first used for human abdominal trauma patients having damage control surgery with an open abdomen, but it has also been used with abdominal sepsis, abdominal compartment syndrome, or to manage organ donors. Direct peritoneal resuscitation involves IP installation of a solution containing dextrose and electrolytes, typically a peritoneal dialysis solution. The glucose and its breakdown products cause abdominal organ vasodilation improving perfusion.
Additionally, because the dialysate is hypertonic, it draws water out of the organs, reducing cellular edema and apoptosis, and improving vascular tone and organ perfusion. Direct peritoneal resuscitation has been shown to decrease tissue necrosis, reduce immune reaction and inflammation, decrease organ edema and improve mortality. However, it is in it's infancy in human medicine and to the author's knowledge has not been used in animals.
In conclusion, the intraperitoneal route can be used for fluid and blood product therapy, euthanasia and for other critical care techniques such as peritoneal dialysis. Human techniques, such as direct peritoneal resuscitation, may or may not translate to veterinary medicine.
Form Title Download
Form Title Bookmark
Form Title Share
Form Title Cite
