Direct peritoneal resuscitation in sepsis and intra-abdominal infection: A scoping review

Table 1 Baseline characteristics of included studies, mean ± SD

Ref.	Study design	Male sex at direct peritoneal resuscitation group	Age at direct peritoneal resuscitation group	Intervention	Total population	Context	Follow-up	Peritoneal solution	Direct peritoneal resuscitation duration
Smith et al[16], 2014	Prospective cohort	27	52 ± 12 years	Direct peritoneal resuscitation	Adults (n = 44 vs 44)	Sepsis patients undergoing damage control surgery	Early physiologic assessment at 24-48 hours; in-hospital follow-up	2.5% DELFLEX	800 mL bolus, then 400 mL/hour continuous infusion until repeat laparotomy
Ji et al[7], 2025	Laboratory-controlled trial (in vivo) animal model	Not applicable	Not applicable	Direct peritoneal resuscitation	Rats (n = 48, 6 groups, n = 8 per group)	Sepsis induced by cecal ligation and puncture	24 hours	Peritoneal lavage with normal saline, Lac-peritoneal dialysis solution (peritoneal lavage with 2.5% Glu-lac-peritoneal dialysis solution) and Pyr-peritoneal dialysis solution (peritoneal lavage with 2.5% Glu-Pyr-peritoneal dialysis solution) (80 mL/hour)	3 hours (80 mL/hour)
Hopkins et al[19], 2011	Two case-series	1 (50%)	31-week gestation and 27-week gestation	Direct peritoneal resuscitation	Infants (n = 2)	Necrotizing enterocolitis	Not mentioned	2.5% dextrose-based peritoneal dialysis solution with added antiseptic (Clorpactin® WCS-90) ± antibiotic (cefazolin)	25-50 mL or 25 mL/kg every 8-12 hours, intermittent, duration guided by clinical tolerance (up to 7 days)
Okumura et al[17], 2022	Prospective single-arm cohort	23 (62%)	Median age (interquartile range) = 62 (53-70) years	Direct peritoneal resuscitation	Adults (n = 37)	Ischemic bowel and sepsis undergoing damage control surgery	30 days (in-hospital)	2.5% glucose-based peritoneal dialysis solution (DELFLEX®)	Median 4 days (interquartile range 2-8)
Cheu et al[18], 1988	Retrospective cohort	Not reported	28.8 ± 3.5 weeks	Primary peritoneal drainage	Infants (n = 92)	Neonates with necrotizing enterocolitis	2 months-3 years	Warm saline (intraoperative irrigation)	Intermittent drainage; no defined infusion duration

Table 2 Quality assessment of observational studies using the Newcastle–Ottawa Scale

Ref.	Study design	Selection	Comparability	Outcome	Total
Smith et al[16], 2014	Sequential prospective cohort	4	2	3	9
Okumura et al[17], 2022	Prospective cohort	4	1	3	8
Cheu et al[18], 1988	Retrospective cohort	3	0	3	6
Ji et al[7], 2025	Not applicable (non-comparative/mechanistic)	Not applicable	Not applicable	Not applicable	Not applicable
Hopkins et al[19], 2011	Case report (2 cases)	Not applicable	Not applicable	Not applicable	Not applicable