Читать книгу Gastrointestinal Surgical Techniques in Small Animals - Группа авторов - Страница 100

Since patients with abdominal drainage have some form of peritonitis, it is important to monitor those patients with electrocardiogram and arterial pressure measurement.

Hypovolemia, hypotension, arrhythmias, and disseminated intravascular coagulation are the common complications related to abdominal drainage and peritonitis. Monitoring urine production with a urinary catheter and a close collection system is important to adjust fluid therapy. Evaluation of electrolytes, glucose, and lactate are paramount to monitor and support the patients.

During abdominal drainage it is important to replace the losses to prevent hypovolemia. It is then important to add either synthetic colloids or plasma to maintain oncotic pressure.

Intra‐abdominal compartment syndrome affects cardiac function, respiratory function, kidney function, and intracranial pressure (Diebel et al. 1992; Schein et al. 1995; Ivatury et al. 2001; Madback and Dangleben 2015). Abdominal drainage should therefore help to prevent this syndrome, which aggravates the clinical status of the patient. Monitoring intra‐abdominal pressure is possible with a urinary catheter and a water manometer (Way and Monnet 2014; Madback and Dangleben 2015).

Septic peritonitis in dogs and cats is associated with a 30% mortality rate (Ludwig et al. 1997; Staatz et al. 2002; Davis et al. 2018). However, this prognosis is greatly affected by the underlying condition causing the peritonitis. Septic bile peritonitis carries a worse prognosis, with a mortality rate as high as 73% mortality, and the utilization of an open abdomen did not improve outcome (Ludwig et al. 1997).