Acute peritoneal dialysis in very low birth weight neonates using a vascular catheter

Yu, Jae Eun; Park, Moon Sung; Pai, Ki Soo

doi:10.1007/s00467-009-1347-y

Cited by 49 publications

(42 citation statements)

References 14 publications

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“…One possible explanation for these differences is the source of the data in these reports; i.e., the patients had different primary diseases and there were marked differences in the treatment conditions, including the kind of delivery dialysis system as well as the use or not of antibiotic prophylaxis [5][6][7][8][20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Acute dialysis-associated peritonitis in children with D+ hemolytic uremic syndrome

et al. 2011

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Acute peritoneal dialysis (PD) is the preferred therapy for renal replacement in children with post-diarrheal hemolytic uremic syndrome (D+ HUS), but peritonitis remains a frequent complication of this procedure. We reviewed data from 149 patients with D+ HUS who had undergone acute PD with the aim of determining the prevalence and risk factors for the development of peritonitis. A total of 36 patients (24.2%) presented peritonitis. The median onset of peritonitis manifestations was 6 (range 2-18) days after the initiation of dialysis treatment, and Gram-positive microorganisms were the predominant bacterial type isolated (15/36 patients). The patients were divided into two groups: with or without peritonitis, respectively. Univariate analysis revealed that a longer duration of the oligoanuric period, more days of dialysis, catheter replacement, stay in the intensive care unit, and hypoalbuminemia were significantly associated to the development of peritonitis. The multivariate analysis, controlled by duration of PD, identified the following independent risk factors for peritonitis: catheter replacement [p = 0.037, odds ratio (OR) 1.33, 95% confidence interval (CI) 1.02-1.73], stay in intensive care unit (p = 0.0001, OR 2.62, 95% CI 1.65-4.19), and hypoalbuminemia (p = 0.0076, OR 1.45, 95% CI 1.10-1.91). Based on these findings, we conclude that the optimization of the aseptic technique during catheter manipulation and early nutritional support are targets for the prevention of peritonitis, especially in critically ill patients.

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Section: Discussionmentioning

confidence: 99%

Acute dialysis-associated peritonitis in children with D+ hemolytic uremic syndrome

et al. 2011

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“…90 If peritoneal dialysis is felt to be a short-term requirement, a temporary catheter can be placed. Several studies describe successful peritoneal dialysis by several different techniques in critically ill neonates as small as 830 g. [91][92][93][94][95] When PD is technically difficult because of abdominal wall defects, skin infections, communication to the pleural space, or high ultrafiltration needs, CRRT can be performed. CRRT is performed with a hemodialysis catheter placed in a central location and either regional or systemic anticoagulation.…”

Section: Neonatal Cardiac Surgerymentioning

confidence: 99%

Neonatal Acute Kidney Injury

et al. 2015

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In recent years, there have been significant advancements in our understanding of acute kidney injury (AKI) and its impact on outcomes across medicine. Research based on single-center cohorts suggests that neonatal AKI is very common and associated with poor outcomes. In this state-of-the-art review on neonatal AKI, we highlight the unique aspects of neonatal renal physiology, definition, risk factors, epidemiology, outcomes, evaluation, and management of AKI in neonates. The changes in renal function with gestational and chronologic age are described. We put forth and describe the neonatal modified Kidney Diseases: Improving Global Outcomes AKI criteria and provide the rationale for its use as the standardized definition of neonatal AKI. We discuss risk factors for neonatal AKI and suggest which patient populations may warrant closer surveillance, including neonates ,1500 g, infants who experience perinatal asphyxia, near term/ term infants with low Apgar scores, those treated with extracorporeal membrane oxygenation, and those requiring cardiac surgery. We provide recommendations for the evaluation and treatment of these patients, including medications and renal replacement therapies. We discuss the need for long-term follow-up of neonates with AKI to identify those children who will go on to develop chronic kidney disease. This review highlights the deficits in our understanding of neonatal AKI that require further investigation. In an effort to begin to address these needs, the Neonatal Kidney Collaborative was formed in 2014 with the goal of better understanding neonatal AKI, beginning to answer critical questions, and improving outcomes in these vulnerable populations.

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“…Oyachi et al describe the use of a flexible Blake silicone drain in a term infant requiring PD (28). Yu et al detail the novel use of a vascular catheter placed in the upper right quadrant; however, high rates of catheter leak, poor drainage, and kinking were noted (29).…”

Section: Discussionmentioning

confidence: 99%

“…NICU is a tertiary unit with 40 beds, caring for neonates with both surgical and medical diseases. We usually perform PD if the patient has one of the following: physical evidence of total fluid overload and positive fluid balance, inadequate urine output (<1 mL/kg per hour) or anuria unresponsive to fluid challenge, intravenous furosemide for at least 4 h, acidbase or electrolyte disturbance unresponsive to medical treatment (pH < 7.10, serum K + > 8 mmol/L), progressive azotemia, hyperammonemia, and accumulation of neurotoxic metabolites (5,6).…”

Section: Methodsmentioning

confidence: 99%

Peritoneal Dialysis in Neonates: Six Years Single Centre Experince

Özlü¹,

Yapıcıoğlu²,

Seker³

et al. 2018

Turk J Med Sci

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Background/aim: Peritoneal dialysis (PD) is generally considered the practical dialysis modality for neonates in the treatment of acute kidney injury (AKI) and metabolic disturbances. The aim of this study was to evaluate the indications, complications, and outcomes of PD between January 2011 and December 2016. Materials and methods:This study included all 56 neonates that underwent PD over six years in our neonatal intensive care unit (NICU). A retrospective chart review was performed for all patients in our institution. Results:The incidence of PD was 1.32% (56/4230 patients) during this period. Mean birth weight of the patients was 2267.77 ± 1060.63 (540-5050) g. Thirty-four (60.7%) patients were premature. Fourteen patients (25%) were in the postoperative period of cardiac surgery due to congenital cardiac defects, fourteen patients (25%) were diagnosed with metabolic diseases, one patient had hypoxic ischemic encephalopathy, and another patient had severe pulmonary hypertension. Conclusion:In the acute setting of a neonatal intensive care unit, PD performed in a neonate provides a technically simple method of steady fluid, solute removal, and correction of electrolyte abnormalities. A trocar catheter appears safe even in premature babies, and closed three-way stopcock system seems to be reliable at the bedside in NICUs.

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Acute peritoneal dialysis in very low birth weight neonates using a vascular catheter

Cited by 49 publications

References 14 publications

Acute dialysis-associated peritonitis in children with D+ hemolytic uremic syndrome

Acute dialysis-associated peritonitis in children with D+ hemolytic uremic syndrome

Neonatal Acute Kidney Injury

Peritoneal Dialysis in Neonates: Six Years Single Centre Experince

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