Effects of different techniques of peritoneal dialysis at the intra-abdominal pressure in a newborn



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Introduction. Peritoneal dialysis (PD) is considered a very effective care for newborns with severe acute renal injury , and it is a method of choice for treating newborns in the end-stage renal failure who require chronic renal replacement therapy (RRT). The classical modification of peritoneal dialysis involves the introduction of dialysis solution into the abdominal cavity, its presence there for a certain time (exposure time) and its passive evacuation from the abdominal cavity. However, this technique of peritoneal dialysis causes an increased intra-abdominal pressure leading to a number of complications. PD in premature newborns, including those with extremely low body weight, has a number of features associated with extremely immature organs and tissues. One more problem is hemodynamic instability in this category of patients. Besides, peritoneal dialysis in the classical modification accompanied by increase in the intra-abdominal pressure can cause hemodynamic and respiratory disorders. The purpose of this article is to demonstrate the effect of the modified peritoneal dialysis, developed by the authors, at the intraabdominal pressure and compare it with the classical approach.
Material and methods. A method of flow peritoneal dialysis in premature newborns has been developed, which significantly reduces the effect of peritoneal dialysis at the intra-abdominal pressure. Intra-abdominal pressure monitoring was performed using the invasive low pressure meter IInd 500/75 Triton. The values of intra-abdominal pressure in children receiving renal replacement therapy with various modifications of peritoneal dialysis were compared.
Results. Our observations show that peritoneal dialysis in the flow modification avoids sharp fluctuations in intra-abdominal pressure. Conclusion. In our opinion, flow modification of peritoneal dialysis may be the method of choice for replacement therapy in deeply premature infants with low and extremely low birth weight.

作者简介

M. Rekhviashvili

Morozov Children’s City Clinical Hospital; Speransky Children’s City Clinical Hospital No 9

编辑信件的主要联系方式.
Email: dr.rekhviashvili@yandex.ru
ORCID iD: 0000-0003-2256-6198

MD, pediatric surgeon at surgical department; pediatric surgeon at Center of neonatal nephrology and dialysis

Moscow, 119049

Moscow, 123317

俄罗斯联邦

A. Razumovskiу

Pirogov Russian National Research Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0002-9497-4070

Moscow, 117997

俄罗斯联邦

A. Makulova

Pirogov Russian National Research Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0001-9952-3159

Moscow, 117997

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S. Fomenko

Pirogov Russian National Research Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0001-6515-0892

Moscow, 117997

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G. Tukabaev

Pirogov Russian National Research Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0003-0147-4649

Moscow, 117997

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V. Syt’kov

Morozov Children’s City Clinical Hospital; A.I. Yevdokimov Moscow State University of Medicine and Dentistry

Email: fake@neicon.ru
ORCID iD: 0000-0001-6152-5693

Moscow, 119049

Moscow, 127473

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参考

  1. Durand P.Y., Chanliau J., Gamberoni J., Hestin D., Kessler M. Intraperitoneal pressure, peritoneal permeability and volume of ultrafiltration in CAPD. Adv Perit Dial. 1992; 8: 22–5.
  2. Mathieu B., Pillot A. ALTIR nursing team. Measurement of hydrostatic intraperitoneal pressure. Adv Perit Dial. 1994; 10: 59–62
  3. Blasco-Cabanas C., Ponz-Clemente E., Betancourt-Castellanos L., Otero-López S., Marquina-Parra D., Gran-Pueyo C., et al. Relación entre la presión intraabdominal endiálisis peritoneal con las hernias y fugas. Enferm Nefrol. 2012; 2: 94–100.
  4. Abensur H., Romao J.E.Jr., Brandao de Almeida Prado E., Kakehashi E., Sabbaga E., Marcondes M. Influence of the hydrostatic intraperitoneal pressure and the cardiac function on the lymphatic absorption rate of the peritoneal cavity in CAPD. Adv Perit Dial. 1993; 9: 41–5.
  5. Durand P.Y., Chanliau J., Gamberoni J., Hestin D., Kessler M. APD: clinical measurement of the maximal acceptable intraperitoneal volume. Adv Perit Dial. 1994; 10: 63–7.
  6. Aranda R.A., Romão Júnior J.E., Kakehashi E., Domingos W., Sabbaga E., Marcondes M., et al. Intraperitoneal pressure and hernias in children on peritoneal dialysis. Pediatr Nephrol. 2000; 14: 22–4.
  7. Scanziani R., Dozio B., Baragetti I., Maroni S. Intraperitoneal hydrostatic pressure and flow characteristics of peritoneal catheters in automated peritoneal dialysis. Nephrol Dial Transplant. 2003; 18: 2391–8.
  8. Dejardin A., Robert A., Goffin E. Intraperitoneal pressure in PD patients: relationship to intraperitoneal volume, body size and PD-related complications. Nephrol Dial Transplant. 2007; 22: 1437–44.
  9. Fischbach M., Terzic J., Laugel V., Escande B., Dangelser C.I., Helmstetter A. Measurement of hydrostatic intraperitoneal pressure: a useful tool for the improvement of dialysis dose prescription. Pediatr Nephrol. 2003; 18: 976–80.
  10. Durand P.Y., Chanliau J., Gamberoni J., Hestin D., Kessler M. Measurement of hydrostatic intraperitoneal pressure: a necessary routine test in peritoneal dialysis. Perit Dial Int. 1996; 16(Suppl. 1): 84–7.
  11. Добросердов Д.А., Щебеньков М.В., Шавкин А.Л. Хирургические осложнения перитонеального диализа у детей с хронической почечной недостаточностью. Детская хирургия. 2020; 24(5): 297–302.
  12. Paniagua Sierra J.R., Ventura García M.J., Vázquez Hernández R. Aumento dela presión intra abdominalyotras complicaciones. In: Montenegro J., Correa-Rotter R., Riella M., ed. Tratado de diálisis peritoneal. Barcelona: Elsevier Espana˜ SL; 2009: 349–60.
  13. Durand P.Y., Chanliau J., Gamberoni J., Hestin D., Kessler M. Intraperitoneal hydrostatic pressure and ultrafiltration in CAPD. Adv Perit Dial. 1993; 9: 46–8.
  14. Flessner M.F. Peritoneal ultrafiltration: physiology and failure. Contrib Nephrol. 2009; 163: 7–14
  15. Fischbach M., Terzic J., Provot E., Weiss L., Bergere V., Menouer S., Soulami K. Intraperitoneal pressure in children: fill-volume related and impacted by body mass index. Peritoneal Dialysis International. Journal of the International Society for Peritoneal Dialysis. 200301 Jul; 23(4): 391-4.
  16. Sanchez N., Tenofsky P., Dort J., Shen L., Helmer S., Smith R. What is normal intra-abdominal pressure? Am Surg. 2001; 67: 243–8.
  17. Outerelo M.C., Gouveia R., Teixeira-Costa F., Ramos A. Intraperitoneal pressure has a prognostic impact on peritoneal dialysis patients. Perit Dial Int. 2014; 34: 652–4.
  18. Twardowski Z.J., Prowant B.F., Nolph K.D., Martínez A.J., Lampton L.M. High volume, low frequency continuous ambulatory peritoneal dialysis. Kidney Int. 1983; 23: 64–70.
  19. Durand P.Y., Balteau P., Chanliau J., Kessler M. Optimization of fill volumes in automated peritoneal dialysis. Perit Dial Int. 2000; 20(Suppl. 2): 83–8.
  20. Fischbach M., Terzic J., Gaugler C., Bergere V., Munch K., Hamel G., et al. Impact of increased intraperitoneal fill volume on tolerance and dialysis effectiveness in children. Adv Perit Dial. 1998; 14: 258–64.
  21. Fischbach M., Desprez P., Donnars F., Geisert J. Hydrostatic intraperitoneal pressure in children on peritoneal dialysis: practical implications: an 18 month clinical experience. Adv Perit Dial. 1994; 10: 294–6.
  22. Fischbach M., Dheu C. Hydrostatic intraperitoneal pressure: an objective tool for analyzing individual tolerance of intraperitoneal volume. Perit Dial Int. 2005; 25: 338–9.
  23. Rusthoven E., van der Vlugt M.E., van Lingen-van Buereb L.J., van Schaijk T.C., Willems H.L., Monnens L.A., et al. Evaluation of intraperitoneal pressure and the effect of different osmotic agents on intraperitoneal pressure in children. Perit Dial Int. 2005; 25: 352–6.
  24. Gotloib L., Mines M., Garmizo L., Varka I. Hemodynamic effects of increasing intraabdominal pressure in peritoneal dialysis. Perit Dial Bull. 1981; 1: 41–3.
  25. Ventura Mde J., Amato D., Correa-Rotter R., Paniagua R. Relationship between fill volume, intraperitoneal pressure, body size and subjective discomfort perception in CAPD patients. Perit Dial Int. 2000; 20: 188–93.
  26. Durand P.Y., Balteau P., Chanliau J., Kessler M. Optimization of fill volumes in automated peritoneal dialysis. Perit Dial Int. 2000; 20(Suppl. 2:) 83–8.
  27. Teitelbaum I. Ultrafiltration failure in peritoneal dialysis: a pathophysiologic aproach. Blood Purif. 2015; 39: 70–3.
  28. Fischbach M., Zaloszyc A., Schaefer B., Schmitt C.P. Optimizing peritoneal dialysis prescription for volume control: the importance of varying dwell time and dwell volume. Pediatr Nephrol. 2014; 29: 1321–7.

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