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professional writing website (paralytic ileus) viagra nedir video. The return of gi motility may take days, weeks, and occasionally, months. In the interim, enteral or parenteral nutrition as indicated facilitates improved immune function and wound healing to ensure recovery. Nonpharmacologic therapy »» drainage procedures primary peritonitis is treated with antimicrobials and rarely requires drainage. Secondary peritonitis requires surgical removal of the inflamed or gangrenous tissue to prevent further bacterial contamination. If the surgical procedure is suboptimal, attempts are made to provide drainage of the infected or gangrenous structures. The drainage of purulent material is the critical component of management of an intra-abdominal abscess. This may be performed surgically or with percutaneous image-guided techniques. 14 without adequate drainage of the abscess, antimicrobial therapy and fluid resuscitation can be expected to fail. The most valuable microbiologic information may be obtained at the time of percutaneous or operative abscess drainage. Other diagnostic tests abdominal radiographs may be useful because free air in the abdomen (indicating intestinal perforation) or distension of the small or large bowel is often evident. »» fluid therapy in patients with peritonitis, hypovolemia is often accompanied by acidosis, and large volumes of an intravenous solution such as lactated ringer may be required initially to restore intravascular volume. Maintenance fluids should be instituted (after intravascular volume is restored) with 0. 9% sodium chloride and potassium chloride (20 meq/l [20 mmol/l]) or 5% dextrose and 0. 45% sodium chloride with potassium chloride (20 meq/l [20 mmol/l]). The administration rate should be based on estimated daily fluid loss through urine and nasogastric suction, including 0. 5 to 1. 0 l for insensible fluid loss. Aggressive fluid therapy often must be continued in the postoperative period because fluid will continue to sequester in the peritoneal cavity, bowel wall, and lumen. Pharmacologic therapy »» antimicrobial therapy the goals of antimicrobial therapy are as follows.

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