Acute peritoneal access and high frequency peritoneal dialysis in intensive care patients
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:180A 1997
The authors report their experience with peritoneal dialysis (PD) in 25 patients in the ICU, using a double-cuff Tenckhoff catheter inserted using a Seldinger technique with a peel-away introducer. PD was delivered using frequent (q1-2h) 1.5 liter exchanges. Mortality was 40%, and peritonitis did not occur.
What is new here? The bedside double-cuff catheter, obviously, and the effect of that is hard to evaluate, since there are few data in the abstract. The zero incidence of peritonitis is impressive, as is the low incidence (3/25) of catheter failure, although both would be more so if we knew the duration of PD in these patients. Since almost all were treated with mechanical ventilation and vasopressors, one assumes that the duration of dialysis dependence must have been weeks in some cases, although assumptions can be misleading. The thrust of the abstract is to demonstrate the viability of PD as an alternative therapy in the ICU, but I am not aware that that was in question. More emphasis and information on the catheter technique would be of great interest. (Robert H. Barth, M.D., VA Medical Center, Brooklyn, NY)
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ASN 30th Annual Meeting, San Antonio
Basic hemodialysis : (Intermittent) dialysis for ARF