Relación entre la presión intrabdominal en diálisis peritoneal con las hernias y fugas

The measure of intraperitoneal pressure in peritoneal dialysis is easy and provides clear therapeutic benefits. However it is measured only rarely in adult peritoneal dialysis units. This review aims to disseminate the usefulness of measuring intraperitoneal pressure. This measurement is performed in supine before initiating the drain of a manual exchange with "Y" system, by raising the drain bag and measuring from the mid-axillary line the height of the liquid column that rises from the patient. With typical values of 10-16 cmHO, intraperitoneal pressure should never exceed 18 cmHO. With basal values that depend on body mass index, it increases 1-3 cmHO/L of intraperitoneal volume, and varies with posture and physical activity. Its increase causes discomfort, sleep and breathing disturbances, and has been linked to the occurrence of leaks, hernias, hydrothorax, gastro-esophageal reflux and enteric peritonitis. Less known and valued is its ability to decrease the effectiveness of dialysis significantly counteracting ultrafiltration and decreasing solute clearance to a smaller degree. Because of its easy measurement and potential utility, should be monitored in case of ultrafiltration failure to rule out its eventual contribution in some patients. Although not yet mentioned in the clinical practice guidelines for PD, its clear benefits justify its inclusion among the periodic measurements to consider for prescribing and monitoring peritoneal dialysis.

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La presión intraperitoneal en diálisis peritoneal

Díaz

Ballesteros

García

et al. 2017

Nefrología

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Intraperitoneal pressure in peritoneal dialysis

Díaz

Ballesteros

García

et al. 2017

Nefrología (English Edition)

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

Rekhviashvili

Razumovskiу

Makulova

et al. 2021

Russian Journal of Pediatric Surgery

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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.

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Relación entre la presión intrabdominal en diálisis peritoneal con las hernias y fugas

Abstract: Normal intra-abdominal pressure is equal to atmospheric pressure (zero). In peritoneal dialysis the introduction of intra-peritoneal liquid increases intra-abdominal pressure. In various studies it is recommended that this does not exceed 16-20cm H 2 O.

Cited by 8 publications

References 7 publications

La presión intraperitoneal en diálisis peritoneal

La presión intraperitoneal en diálisis peritoneal

Intraperitoneal pressure in peritoneal dialysis

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

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